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Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel

Although increased cross-sectional area of the median nerve on ultrasound has been associated with carpal tunnel syndrome, there has been little research examining outlier cases with exceedingly large nerves. The purpose of this study was to identify factors associated with these “mega” nerves, and...

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Autores principales: Kohls, Morgan R., Wasil, Karen F., Fowler, John R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592521/
https://www.ncbi.nlm.nih.gov/pubmed/36299818
http://dx.doi.org/10.1097/GOX.0000000000004597
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author Kohls, Morgan R.
Wasil, Karen F.
Fowler, John R.
author_facet Kohls, Morgan R.
Wasil, Karen F.
Fowler, John R.
author_sort Kohls, Morgan R.
collection PubMed
description Although increased cross-sectional area of the median nerve on ultrasound has been associated with carpal tunnel syndrome, there has been little research examining outlier cases with exceedingly large nerves. The purpose of this study was to identify factors associated with these “mega” nerves, and to determine whether these nerves carry with them increased severity of disease. METHODS: Patients who presented to clinic with upper extremity paresthesias over a 4-year period were included in this study. Two groups were created: mega nerves (cross-sectional area >2 SD above average), and nonmega nerves. Statistical analysis was performed to compare demographics, symptom scores, and nerve conduction studies (NCS). Significant variables were then compared between patients with mega nerves and those with ultrasound positive nerves (≥10 mm(2)), which did not reach mega size (normal nerves were excluded). RESULTS: The cohort included 425 median nerves with 25 mega nerves. The groups differed significantly in diabetes status, body mass index (BMI), Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale scores, and NCS results. When compared only with ultrasound positive but nonmega nerves, mega nerves were still associated with diabetes, higher BMI, and worse NCS results. CONCLUSIONS: Diabetes, BMI, NCS results, and BCTQ Symptom Severity Scale scores are associated with mega nerves. However, BCTQ scores do not differ between mega nerves and other ultrasound positive nerves. In patients with obesity or diabetes, outlier ultrasound measurements may not correlate with worsened clinical symptoms, even in the setting of more significantly altered NCS results.
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spelling pubmed-95925212022-10-25 Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel Kohls, Morgan R. Wasil, Karen F. Fowler, John R. Plast Reconstr Surg Glob Open Peripheral Nerve Although increased cross-sectional area of the median nerve on ultrasound has been associated with carpal tunnel syndrome, there has been little research examining outlier cases with exceedingly large nerves. The purpose of this study was to identify factors associated with these “mega” nerves, and to determine whether these nerves carry with them increased severity of disease. METHODS: Patients who presented to clinic with upper extremity paresthesias over a 4-year period were included in this study. Two groups were created: mega nerves (cross-sectional area >2 SD above average), and nonmega nerves. Statistical analysis was performed to compare demographics, symptom scores, and nerve conduction studies (NCS). Significant variables were then compared between patients with mega nerves and those with ultrasound positive nerves (≥10 mm(2)), which did not reach mega size (normal nerves were excluded). RESULTS: The cohort included 425 median nerves with 25 mega nerves. The groups differed significantly in diabetes status, body mass index (BMI), Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale scores, and NCS results. When compared only with ultrasound positive but nonmega nerves, mega nerves were still associated with diabetes, higher BMI, and worse NCS results. CONCLUSIONS: Diabetes, BMI, NCS results, and BCTQ Symptom Severity Scale scores are associated with mega nerves. However, BCTQ scores do not differ between mega nerves and other ultrasound positive nerves. In patients with obesity or diabetes, outlier ultrasound measurements may not correlate with worsened clinical symptoms, even in the setting of more significantly altered NCS results. Lippincott Williams & Wilkins 2022-10-24 /pmc/articles/PMC9592521/ /pubmed/36299818 http://dx.doi.org/10.1097/GOX.0000000000004597 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Peripheral Nerve
Kohls, Morgan R.
Wasil, Karen F.
Fowler, John R.
Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel
title Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel
title_full Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel
title_fullStr Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel
title_full_unstemmed Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel
title_short Mega Nerves: Factors Associated with Large Median Nerves on Ultrasound of the Carpal Tunnel
title_sort mega nerves: factors associated with large median nerves on ultrasound of the carpal tunnel
topic Peripheral Nerve
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592521/
https://www.ncbi.nlm.nih.gov/pubmed/36299818
http://dx.doi.org/10.1097/GOX.0000000000004597
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