Park1腕管综合征得朝圣诊断的价值课件.pptVIP

The Diagnostic Value of Ultrasonographic Measurement in Carpal Tunnel Syndrome Gi-Young Park1, Jung-Ho Bae2 Department of Rehabilitation Medicine, 1 Catholic University of Daegu School of Medicine, 2 Keimyung University School of Medicine Nanjing Carpal Tunnel Syndrome Nerve Conduction Study Imaging Studies for Diagnosis of CTS Plain radiograph Computed tomography (CT) Magnetic resonance imaging (MRI) Ultrasonography Ultrasonography Transverse sonograms of carpal tunnel of wrist show normal appearance of median nerve (black arrows) and flexor tendons (white arrows). r = radial, u = ulnar Objectives To compare the ultrasonographic measurements in patients with CTS, diagnosed by NCS, to those obtained from control subjects To investigate their correlations with the severity of CTS determined by NCS To evaluate the diagnostic value of the ultrasonographic measurement being the highest correlating with NCS Methods Patients Characteristics CTS1 Controls Age (years) 53.8 ± 9.6 (28-78) 49.9 ± 7.8 (28-62) Sex (M/F) 10 / 90 2 / 38 Wrists (M/F) 13 / 115 4 / 57 Values are mean ± standard deviation (range). 1. CTS: Carpal tunnel syndrome Exclusion Criteria Systemic conditions such as diabetes mellitus, thyroid disease, chronic renal failure under hemodialysis, rheumatoid arthritis, and myxedma Orthopedic conditions such as previous wrist fracture or surgery, and CTS surgery Clinical or electrodiagnostic evidence of an accompanying conditions such as cervical radiculopathy and polyneuropathy Ultrasonographic evidence of the bifid median nerve and mass lesions Negative NCS. Neurophysiologic Grading Scale for CTS Grade 0 (normal): no neurophysiological abnormalities Grade 1 (very mild): only in two sensitive tests (eg, inching, palm/wrist median/ulnar comparison, ring finger “double peak” Grade 2 (mild): orthodromic sensory conduction velocity form index finger to wrist 40 m/s with motor terminal latency from wrist to abductor pollicis