Assessment of Severity by High Resolution Ultrasonography in Carpal
Tunnel Syndrome

J Korean Neurol Assoc > Volume 30(3); 2012 > Article

Journal of the Korean Neurological Association 2012;30(3): 176-181.

초음파검사를 이용한 수근관증후군의 중증도 평가

정일영, 김남희 정경숙 양혜란 박경석

동국대학교 일산병원 신경과, 동국대학교 일산병원 직업환경의학과 a , 분당서울대학교병원 신경과 b

Assessment of Severity by High Resolution Ultrasonography in Carpal Tunnel Syndrome

Il Young Jung

Department of Neurology, Dongguk University International Hospital, Ilsan, Korea Department of Occupational and Environmental Medicine a , Dongguk University International Hospital, Ilsan, Korea Department of Neurology b , Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Background: Background: Although nerve conduction study (NCS) is the method most frequently used to confirm clinical diagnosis of carpal tunnel syndrome (CTS), ultrasonographic (US) measurement can give additional information to confirm the diagnosis and also exclude other conditions of nearby soft tissues. However, whether or not the degree of swelling of median nerve (MN) reflects clinical severity has not been proven before. This study is aimed to investigate the further clinical usefulness of US in assessing CTS severity.
Methods: One hundred and twenty-four patients (248 hands) with electrophysiologically confirmed CTS were evaluated. Clinical severity was examined by Historic and Objective (Hi-Ob) scale. Padua scale was used for the severity of electrophysiological impairment. For US study, cross-sectional area (CSA) of the median nerve was measured at the proximal inlet of the carpal tunnel and graded.
Results: Ninety-four patients were female (75%) and median disease duration was 19 weeks. There was a good correlation between electrophysiological impairment and CSA of median nerve (correlation coefficient=0.442, p<0.001), and CSA was graded as US severity scale by electrophysiological severity of patients. A statistically significant correlation was found among US severity scale of the MN at wrist, clinical severity scale (correlation coefficient=0.397, p<0.001), and electrophysiological severity scale (correlation coefficient=0.371, p<0.001).
Conclusions: This observation suggests MN swelling in CTS may reflect in itself the degree of nerve damage as expressed by the clinical picture. US measurement could also give additional information about severity of MN involvement above the diagnosis of CTS. Key Words: Carpal tunnel syndrome, Cross sectional area, Nerve conduction study, Severity, Ultrasonography