Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study

OBJECTIVE: To investigate the optimal sonographic method for diagnosing carpal tunnel syndrome (CTS) in patients with diabetic sensorimotor polyneuropathy (DSP). METHODS: A total of 190 participants were divided into four groups based on DSP history and electrodiagnostic results of CTS. The absolute...

Descripción completa

Detalles Bibliográficos
Autores principales: Park, Ji Woong, Lee, Seokmin, Jang, Rhee Wook, Lee, Sungche, Lee, Sanghoon, Cho, Hyunchul, Choi, Yoon-Hee, Kwak, Jinmyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Academy of Rehabilitation Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409665/
https://www.ncbi.nlm.nih.gov/pubmed/30852870
http://dx.doi.org/10.5535/arm.2019.43.1.45
_version_ 1783402031725150208
author Park, Ji Woong
Lee, Seokmin
Jang, Rhee Wook
Lee, Sungche
Lee, Sanghoon
Cho, Hyunchul
Choi, Yoon-Hee
Kwak, Jinmyoung
author_facet Park, Ji Woong
Lee, Seokmin
Jang, Rhee Wook
Lee, Sungche
Lee, Sanghoon
Cho, Hyunchul
Choi, Yoon-Hee
Kwak, Jinmyoung
author_sort Park, Ji Woong
collection PubMed
description OBJECTIVE: To investigate the optimal sonographic method for diagnosing carpal tunnel syndrome (CTS) in patients with diabetic sensorimotor polyneuropathy (DSP). METHODS: A total of 190 participants were divided into four groups based on DSP history and electrodiagnostic results of CTS. The absolute parameters were measured at baseline and the relative values were calculated: maximal cross-sectional area (CSA) of the median nerve throughout the carpal tunnel (Mmax), median nerve CSA at the forearm level (Mf), ulnar nerve CSA at the pisiform level (Upi), difference between Mmax and Mf (∆MM), and difference between Mmax and Upi (∆MU). Then, the optimal ultrasonographic parameters for diagnosing CTS, according to the presence of DSP, using absolute and relative cutoff values were analyzed. RESULTS: Median and ulnar nerve CSAs were significantly larger in the DSP group than in the control group. In the DSP participants, the mean Mmax, ∆MM, and ∆MU values were significantly larger in patients with both DSP and CTS than in patients with DSP only. The Mmax thresholds of 9.5 mm(2) in the control group and 11.5 mm(2) in the DSP group showed the greatest sensitivity and specificity for diagnosing CTS. The ∆MM thresholds of 2.5 mm(2) and ∆MU thresholds of 4.5 mm(2) had the greatest sensitivity and specificity in both the DSP and control groups. CONCLUSION: Measurement of Mmax, ∆MM and ∆MU is an optimal ultrasonographic evaluation method for diagnosing CTS in patients with DSP.
format Online
Article
Text
id pubmed-6409665
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Korean Academy of Rehabilitation Medicine
record_format MEDLINE/PubMed
spelling pubmed-64096652019-03-15 Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study Park, Ji Woong Lee, Seokmin Jang, Rhee Wook Lee, Sungche Lee, Sanghoon Cho, Hyunchul Choi, Yoon-Hee Kwak, Jinmyoung Ann Rehabil Med Original Article OBJECTIVE: To investigate the optimal sonographic method for diagnosing carpal tunnel syndrome (CTS) in patients with diabetic sensorimotor polyneuropathy (DSP). METHODS: A total of 190 participants were divided into four groups based on DSP history and electrodiagnostic results of CTS. The absolute parameters were measured at baseline and the relative values were calculated: maximal cross-sectional area (CSA) of the median nerve throughout the carpal tunnel (Mmax), median nerve CSA at the forearm level (Mf), ulnar nerve CSA at the pisiform level (Upi), difference between Mmax and Mf (∆MM), and difference between Mmax and Upi (∆MU). Then, the optimal ultrasonographic parameters for diagnosing CTS, according to the presence of DSP, using absolute and relative cutoff values were analyzed. RESULTS: Median and ulnar nerve CSAs were significantly larger in the DSP group than in the control group. In the DSP participants, the mean Mmax, ∆MM, and ∆MU values were significantly larger in patients with both DSP and CTS than in patients with DSP only. The Mmax thresholds of 9.5 mm(2) in the control group and 11.5 mm(2) in the DSP group showed the greatest sensitivity and specificity for diagnosing CTS. The ∆MM thresholds of 2.5 mm(2) and ∆MU thresholds of 4.5 mm(2) had the greatest sensitivity and specificity in both the DSP and control groups. CONCLUSION: Measurement of Mmax, ∆MM and ∆MU is an optimal ultrasonographic evaluation method for diagnosing CTS in patients with DSP. Korean Academy of Rehabilitation Medicine 2019-02 2019-02-28 /pmc/articles/PMC6409665/ /pubmed/30852870 http://dx.doi.org/10.5535/arm.2019.43.1.45 Text en Copyright © 2019 by Korean Academy of Rehabilitation Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Park, Ji Woong
Lee, Seokmin
Jang, Rhee Wook
Lee, Sungche
Lee, Sanghoon
Cho, Hyunchul
Choi, Yoon-Hee
Kwak, Jinmyoung
Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study
title Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study
title_full Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study
title_fullStr Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study
title_full_unstemmed Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study
title_short Optimal Ultrasonographic Measurements for Diagnosing Carpal Tunnel Syndrome in Patients With Diabetic Sensorimotor Polyneuropathy: A Case-Control Study
title_sort optimal ultrasonographic measurements for diagnosing carpal tunnel syndrome in patients with diabetic sensorimotor polyneuropathy: a case-control study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409665/
https://www.ncbi.nlm.nih.gov/pubmed/30852870
http://dx.doi.org/10.5535/arm.2019.43.1.45
work_keys_str_mv AT parkjiwoong optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT leeseokmin optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT jangrheewook optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT leesungche optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT leesanghoon optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT chohyunchul optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT choiyoonhee optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy
AT kwakjinmyoung optimalultrasonographicmeasurementsfordiagnosingcarpaltunnelsyndromeinpatientswithdiabeticsensorimotorpolyneuropathyacasecontrolstudy