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Clin Med Insights Arthritis Musculoskelet Disord 2020 22;13:1179544120921854. Epub 2020 Jun 22.

Erlanger Sports and Health Institute, Chattanooga, TN, USA.

Purpose: While the double crush phenomena (compression along two points on a nerve) has been established between median neuropathy and cervical radiculopathy, combined suprascapular neuropathy (SSN) and cervical C5/C6 radiculopathy-so-called shoulder double crush syndrome-has not been well examined. We aim to identify the incidence of shoulder double crush syndrome in patients undergoing arthroscopic suprascapular nerve release for SSN.

Methods: One hundred consecutive patients >18 years of age who were positive for SSN on electromyography and motor nerve conduction studies (EMG/NCS) and underwent a suprascapular nerve release were included. Read More

J Ultrason 2020 15;20(81):e90-e94. Epub 2020 Jun 15.

Department of Biophysics, Aydın Adnan Menderes University, Faculty of Medicine , Aydın , Turkey.

To evaluate the sonoelastic response of the median nerve in patients with carpal tunnel syndrome following conservative rehabilitation with splint plus exercise regimens. A total of thirty-five patients diagnosed with mild carpal tunnel syndrome and treated with splint plus exercise therapy; hand resting splint all day for 3 weeks and then only at nights along with nerve gliding exercises in 10 repetitions 3 times a day. The median nerve was evaluated clinically prior to the treatment and at week 6 of therapy using physical examination, electrodiagnostic neurophysiology tests and radiological imaging; Boston Scores, electromyogram, ultrasonography and sonoelastography. Read More

J Korean Neurosurg Soc 2020 Jun 29. Epub 2020 Jun 29.

Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Lipofibromatous hamartoma (LFH) is a rare tumor of the peripheral nerves, which usually involves the median nerve. The authors reported on two rare cases of carpal tunnel syndrome due to LFH of the median nerve. A 49-year-old female patient complained of the mass and symptoms consistent with LFH. Read More

Plast Reconstr Surg Glob Open 2020 Mar 20;8(3):e2692. Epub 2020 Mar 20.

Department of Hand and Wrist Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pa.

Carpal tunnel release (CTR) surgery continues to evolve. Carpal tunnel syndrome remains a primarily clinical diagnosis, although ultrasound has supplemented electrodiagnostic testing as a confirmatory tool. Magnetic resonance imaging of the carpal tunnel has also showed some promise as an alternative method for the examination of the median nerve. Read More

Ultrasound Med Biol 2020 Jun 9. Epub 2020 Jun 9.

Department of Biomedical Engineering, National Cheng Kung University Hospital, Tainan, Taiwan.

Carpal tunnel syndrome commonly occurs in individuals working in occupations that involve use of vibrating manual tools or tasks with highly repetitive and forceful manual exertion. In recent years, carpal tunnel syndrome has been evaluated by ultrasound imaging that monitors median nerve movement. Conventional image analysis methods, such as the active contour model, are typically used to expedite automatic segmentation of the median nerve, but these usually suffer from an arduous manual intervention. Read More

Kidney Res Clin Pract 2020 Jun;39(2):213-220

Mansoura Nephrology & Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Background: Carpal tunnel syndrome (CTS) is one of the most common complications among hemodialysis (HD) patients. This study aimed to assess the prevalence of CTS in HD patients using clinical and noninvasive ultrasound (US) criteria.

Methods: A cross-sectional, observational study was conducted on 94 HD patients to evaluate CTS manifestations and demographic, clinical, and laboratory data. Read More

Medicine (Baltimore) 2020 May;99(21):e20248

Hand Surgery, the Second Hospital of Jilin University, No. 218, Lane Ziqiang, Nanguan District, Changchun City, Jilin.

Rationale: Lipomas are common benign tumors, constituting 16% of soft tissue mesenchymal tumors. They usually occur under the skin or in the large muscles of the thigh, shoulder, or upper arm. There are few reported cases of lipomas located in the forearm and hand muscles, accounting for less than 1% of all lipomas. Read More

J Ultrasound Med 2020 May 27. Epub 2020 May 27.

Division of Radiology, Hopitaux Universitaires de Genève, Geneva, Switzerland.

The most common etiology of carpal tunnel syndrome (CTS) is idiopathic. However, secondary causes of CTS should be considered when symptoms are unilateral, or electrodiagnostic studies are discrepant with the clinical presentation. Imaging of the carpal tunnel should be performed when secondary causes of CTS are suspected. Read More

Hand (N Y) 2020 May 23:1558944720919182. Epub 2020 May 23.

University of Pittsburgh Medical Center, PA, USA.

Ultrasound has been well established as a diagnostic modality for carpal tunnel syndrome, but its prognostic utility has not been deeply investigated. Few studies, showing contradictory results, exist investigating ultrasound results as a predictor of patient outcomes. Patients with ultrasound measurement of the cross-sectional area (CSA) of the median nerve who completed the Boston Carpal Tunnel Questionnaire (BCTQ) and followed up after surgery were included in the study. Read More

J Peripher Nerv Syst 2020 May 12. Epub 2020 May 12.

Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

V122I is one of more than 130 mutations in transthyretin gene associated with hereditary TTR (ATTRv) amyloidosis. Main clinical expression is an infiltrative pseudohypertrophic cardiomyopathy with mild or no neurological symptoms. It is particularly common among African-Americans (prevalence: 3%-4%). Read More

J Ultrasound 2020 May 6. Epub 2020 May 6.

Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy.

Carpal tunnel release for compression of the median nerve at the wrist is a common procedure, often resulting in good clinical outcomes. There are, however, many anatomical variations in and around the carpal tunnel and it is important to be aware of these during carpal tunnel release. After surgery, recurrent carpal tunnel syndrome is uncommon, but difficult to diagnose and treat. Read More

Clin Genet 2020 Jul 4;98(1):19-31. Epub 2020 May 4.

Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d'Enfants, Centre Hospitalier Universitaire de Dijon, Dijon, France.

Heterozygous activating variants in platelet-derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM). Here, we present three new cases of KOGS, including a patient with a novel de novo variant c.1477A > T p. Read More

J Clin Neurophysiol 2020 May 26. Epub 2020 May 26.

Department of Clinical Neurophysiology, Pirkanmaa Hospital District, Medical Imaging Centre and Hospital Pharmacy, Tampere University Hospital, Tampere, Finland.

Purpose: The median nerve cross-sectional area at the wrist (CSA) and the wrist-to-forearm ratio of the cross-sectional areas (WFR) are ultrasound parameters used in the diagnosis and grading of carpal tunnel syndrome. This study aimed to determine the diagnostic accuracy of the CSA and WFR as well as to compare their diagnostic value.

Methods: A retrospective evaluation was conducted of a cohort of 218 patients who had undergone nerve conduction studies (NCSs) and an ultrasound of the median nerve. Read More

Can J Cardiol 2020 Mar 17;36(3):396-407. Epub 2020 Jan 17.

Brigham and Women's Hospital Amyloidosis Program, Division of Cardiovascular Medicine Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

The systemic amyloidoses are a group of diseases characterized by the deposition of amyloid, a material formed from misfolding of proteins, in one or more organs. The 2 commonest forms of amyloidosis are transthyretin amyloidosis (ATTR), derived from wild-type or mutant transthyretin, and light-chain (AL) amyloidosis, derived from abnormal circulating light chains produced by plasma cell dyscrasia. Both frequently involve the heart, producing an infiltrative cardiomyopathy with restrictive pathophysiology. Read More

Pol J Radiol 2019 28;84:e625-e629. Epub 2019 Dec 28.

Gruca Orthopaedic and Trauma Teaching Hospital, Centre of Postgraduate Medical Education, Otwock, Poland.

Entrapment neuropathies constitute a significant albeit still neglected problem in athletes. Currently available diagnostic options in patients with suspected neuropathies, nerve conduction studies, and magnetic resonance imaging have some drawbacks, mostly related to their invasive character, high cost, and limited availability. This paper reviews published articles documenting the use of ultrasound elastography, a novel technique to determine tissue strain, in the evaluation of nerve stiffness in entrapment neuropathy, and it discusses potential pros and cons of this method in the examination of elite athletes. Read More

Pol J Radiol 2019 22;84:e484-e490. Epub 2019 Nov 22.

Maulana Azad Medical College, New Delhi, India.

Compressive neuropathy of the median nerve at the level of the carpal tunnel, known as carpal tunnel syndrome, is the most common entrapment neuropathy, affecting about 0.1-1% of the general population. Magnetic resonance reliably imaged the flexor retinaculum and carpal bones and thus defined the borders of the carpal tunnel. Read More

Ultrasound Med Biol 2020 May 11;46(5):1092-1104. Epub 2020 Feb 11.

Duke Biomedical Engineering, Duke University, Durham, NC.

This work discusses challenges we have encountered in acquiring reproducible measurements of shear wave speed (SWS) in the median nerve and suggests methods for improving reproducibility. First, procedural acquisition challenges are described, including nerve echogenicity, transducer pressure and transmit focal depth. Second, we present an iterative, radon sum-based algorithm that was developed specifically for measuring the SWS in median nerves. Read More

Radiol Med 2020 May 4;125(5):481-490. Epub 2020 Feb 4.

Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133, Milano, Italy.

Objectives: To systematically review the current literature concerning the role of superb microvascular imaging (SMI), a novel Doppler technique that enables detection of fine vessels and slow blood flow, in the evaluation of musculoskeletal disorders.

Methods: An online search of the literature was conducted for the period 2013 to April 2019 and included original articles written in English language. A data analysis was performed at the end of the literature search. Read More

Comput Med Imaging Graph 2020 Mar 20;80:101687. Epub 2020 Jan 20.

Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan. Electronic address:

Carpal tunnel syndrome (CTS) is a clinical disease that caused by the compression of median nerve within carpal tunnel. Traditional examining for CTS is electrodiagnostic (EDx), but the evaluation of EDx is more expensive and time-consuming. In the present day, ultrasound (US) image is used to clinical examining to make up the lack of nerve electrical inspection. Read More

J Neurol Sci 2020 Apr 21;411:116694. Epub 2020 Jan 21.

Department of Kinesiology, McMaster University, Hamilton, ON, Canada. Electronic address:

Carpal tunnel syndrome (CTS) develops from chronic compression of the median nerve. Chronic compression results in a number of vascular, structural and functional changes to the carpal tunnel tissues which ultimately manifest in the characteristic symptoms of CTS. The purpose of this study was to investigate the interplay of median nerve function, median nerve hemodynamics, and finger flexor tendon and subsynovial connective tissue (SSCT) mechanics in CTS patients. Read More

Curr Med Imaging Rev 2019 ;15(3):334-337

Department of Medicine & Rehabilitation, Faculty of Medicine, Baskent University Adana Research and Education Center, Adana, Turkey.

Purpose: In this study, we aim to evaluate the diagnostic value of echogenicity ratio with histogram analyses.

Materials & Methods: This retrospective study was performed on 22 patients with 44 hands. The patients had clinical presentations consistent with CTS, in at one hand. Read More

ANZ J Surg 2020 Jun 26;90(6):1057-1061. Epub 2020 Jan 26.

Department of Orthopedic Surgery, Government Medical College and Hospital, Chandigarh, India.

Background: The aim of this study was to evaluate the accuracy of high-resolution ultrasonography in the diagnosis of carpal tunnel syndrome (CTS).

Methods: It included 50 patients with signs and symptoms suggestive of CTS and 50 individuals as control group. Cross-sectional area of median nerve at the inlet of carpal tunnel was measured in control as well as symptomatic group by ultrasonography. Read More

Korean J Pain 2020 Jan;33(1):54-59

Department of Anesthesiology and Pain Medicine, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

Background: The median nerve cross-sectional area (MNCSA) is a useful morphological parameter for the evaluation of carpal tunnel syndrome (CTS). However, there have been limited studies investigating the anatomical basis of median nerve flattening. Thus, to evaluate the connection between median nerve flattening and CTS, we carried out a measurement of the median nerve thickness (MNT). Read More

BMC Musculoskelet Disord 2019 Dec 29;20(1):634. Epub 2019 Dec 29.

Instituto Poal de Reumatologia, University of Barcelona, Barcelona, Spain.

Background: Carpal tunnel syndrome (CTS) is the commonest entrapment neuropathy. The aim of this study was to assess the accuracy and validity of high resolution musculoskeletal ultrasound (US) in the diagnosis of CTS in the Saudi population.

Methods: Sixty patients were diagnosed clinically to have CTS involving 89 wrists that were confirmed by neurophysiologic studies. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(1):2309499019893079

Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

The association between carpal tunnel syndrome (CTS) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, an elderly onset rheumatic disease, is not fully understood. Here, we describe a case of acute CTS caused by RS3PE syndrome. An 84-year-old man visited the hospital with sudden onset of severe neuralgia in the median nerve and pitting edema in both hands. Read More

Semin Arthritis Rheum 2020 04 9;50(2):329-334. Epub 2019 Nov 9.

Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. Electronic address:

Musculoskeletal (MSK) involvement of the hands is a significant source of morbidity, impacting on quality of life in patients with systemic sclerosis (SSc). MSK complications are common in SSc and can affect the whole of the MSK system. MSK hand involvement can occur early in the course of the disease. Read More

J Orthop Res 2020 May 5;38(5):1038-1044. Epub 2019 Dec 5.

Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.

Cumulative shear strain of the subsynovial connective tissue (SSCT) surrounding finger flexor tendons plays a significant role in the development and progression of carpal tunnel syndrome. Biomechanical risk factors can alter tendon-SSCT shear strain but the effects of external mechanical compression and localized ischemia have yet to be investigated. In a laboratory study with 19 healthy participants, color Doppler ultrasound imaging was used to quantify relative motion between the flexor digitorum superficialis tendon and SSCT during repetitive finger flexion-extension under various conditions of external mechanical compression (palmar and forearm compression), ischemia and different movement speeds (0. Read More

Radiol Med 2020 Feb 26;125(2):197-203. Epub 2019 Nov 26.

Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 1, 16132, Genoa, Italy.

Objective: To assess the discriminative power of radiomics of peripheral nerves at 1.5T MRI, using common entrapment neuropathies of the upper limb as a model system of focal nerve injury.

Materials And Methods: Radiomics was retrospectively done on peripheral nerve fascicles on T1-weighted 1. Read More

Pan Afr Med J 2019 25;34:50. Epub 2019 Sep 25.

Service de Neurologie, CHU Hassan II, Fès, Maroc.

This study aims to evaluate the advantages of ultrasound in the diagnosis of carpal tunnel syndrome by comparing it with electroneuromyography (ENMG). We conducted a cross-sectional study over a period of 6 months. All patients underwent ultrasound with measurement of the surface of the median nerve at the entrance of the carpal tunnel and electroneuromyographic examination of both wrists. Read More

J Pain Res 2019 24;12:2951-2958. Epub 2019 Oct 24.

Physical Medicine and Rehabilitation Department, IKHC Center, Tehran University of Medical Sciences (TUMS), School of Medicine, Tehran, Iran.

Purpose: The present article has investigated the added value of ultrasound (US) guidance on improving the efficacy of local triamcinolone injection via comparing two US-guided methods versus a conventional landmark-guided approach.

Methods: Eighty-one subjects with mild or moderate CTS were included and randomly assigned into three categories including landmark-guided, conventional US-guided midline approach and US-guided ulnar in-plane method. Primarily, participants in the three groups were relatively similar in terms of demographics and their clinical variables comprising visual analog scale (VAS) for pain, pain-free grip strength (PFGS), Boston CTS questionnaire (BCTQ), EDX parameters, and cross-sectional area (CSA) of median nerve measured by ultrasonography. Read More

Eur Radiol 2020 Mar 11;30(3):1498-1506. Epub 2019 Nov 11.

Department of Radiology, Private Institution of Ultrasonography, Athens, Greece.

Background: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence.

Methods: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. Read More

Eklem Hastalik Cerrahisi 2019 Dec;30(3):212-6

Department of Orthopedics and Traumatology, Istanbul Bahçelievler State Hospital, 34186 Bahçelievler, Istanbul, Turkey.

Objectives: This study aims to compare endoscopic carpal tunnel release versus mini-open carpal tunnel release regarding volume changes in the carpal tunnel and median nerve by magnetic resonance imaging (MRI).

Patients And Methods: The study included 17 wrists of 13 patients (1 male, 12 females; mean age 55 years; range, 51 to 64 years) who were diagnosed with carpal syndrome. Ten wrists underwent mini-open carpal tunnel release, while seven wrists underwent uni-portal endoscopic carpal tunnel release. Read More

Brain Topogr 2020 01 14;33(1):22-36. Epub 2019 Sep 14.

School of Physics and Astronomy, Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2RD, UK.

A previously introduced Bayesian non-parametric multi-scale technique, called iterated Multigrid Priors (iMGP) method, is used to map the topographic organization of human primary somatosensory cortex (S1). We analyze high spatial resolution fMRI data acquired at ultra-high field (UHF, 7T) in individual subjects during vibrotactile stimulation applied to each distal phalange of the left hand digits using both a travelling-wave (TW) and event-related (ER) paradigm design. We compare the somatotopic digit representations generated in S1 using the iMGP method with those obtained using established fMRI paradigms and analysis techniques: Fourier-based analysis of travelling-wave data and General Linear Model (GLM) analysis of event-related data. Read More

J Orthop Translat 2019 Jul 14;18:13-19. Epub 2019 Feb 14.

Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.

Background: Owing to the compressive nature of the neuropathy, patients with carpal tunnel syndrome (CTS) have prolonged distal motor latency (DML), sensory nerve latency (SNL), median nerve swelling and restricted median nerve mobility. The purpose of this study was to noninvasively augment carpal tunnel space using radioulnar wrist compression (RWC) and evaluate its effects on median nerve pathological properties in patients with CTS. It was hypothesized that the RWC intervention would reduce the median nerve DML, SNL and cross-sectional area (CSA) and enhance longitudinal median nerve mobility in patients. Read More

Med Lav 2019 Aug 26;110(4):271-277. Epub 2019 Aug 26.

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Background: Occupational tasks characterized by repetitive, awkward and forceful movements of the hand and wrist may heighten the risk of carpal tunnel syndrome (CTS) among dairy parlor workers. Median nerve impairment can be investigated with ultrasonography (US) and nerve conduction studies (NCS) but a structured questionnaire may help identify early symptoms.

Objectives: Our objectives were to: a) compare the sensitivity of US investigations and NCS to detect early signs of CTS; b) explore the correlation of the results of these two tests with CTS symptoms obtained from the administration of a targeted questionnaire. Read More

Eur Radiol 2020 Feb 29;30(2):887-894. Epub 2019 Aug 29.

Department of Musculoskeletal Radiology, Lille University Hospital, Lille, France.

Introduction: Numerous publications have studied the regional anatomy of the carpal tunnel to define a "safe zone" to reduce the risk of perioperative neurovascular complications. This zone, located between the ulnar neurovascular bundle and the median nerve, is considered to be safe mainly because of the absence of vascular structures. This study aims to assess the presence of arterioles within this area using superb microvascular imaging (SMI). Read More

J Bone Miner Metab 2020 Jan 14;38(1):78-85. Epub 2019 Aug 14.

Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

The RDT population, initially at 215 patients, exceeded 300,000 in 2011, with a total of 329,609 patients at the end of December 2016. In our Institute, the number of patients with destructive spondylosis is increasing with the increase in the number of dialysis patients in Japan. We had 14 Cases in the 1990s, and then 82 cases in the 2000s and have already had 131 cases in the 2010s. Read More

Skeletal Radiol 2020 Mar 9;49(3):397-405. Epub 2019 Aug 9.

Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong.

Objective: To study MRI criteria for diagnosing and predicting severity of carpal tunnel syndrome (CTS).

Methods: Sixty-nine wrists in 41 symptomatic CTS patients and 32 wrists in 28 asymptomatic subjects were evaluated by MRI. Circumferential surface area (CSA), flattening ratio, relative median nerve signal intensity, and retinacular bowing were measured. Read More

Rinsho Ketsueki 2019 ;60(7):791-796

Department of Internal Medicine, Toyama Prefectural Central Hospital.

Here, we present the case of a 72-year-old male who presented with swelling, stiffness, and dysesthesia in the bilateral fingers, wrists, and ankles. Although rheumatoid arthritis was initially suspected, laboratory tests were negative for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody. Based on the findings of immune globulin G (IgG)-λ M proteins and 26% plasma cells in the bone marrow, multiple myeloma was diagnosed. Read More

Mol Genet Metab 2020 02 30;129(2):98-105. Epub 2019 Jul 30.

Willink Biochemical Genetics Unit, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester Foundation Trust, Manchester M13 9WL, UK.

The outcome of 110 patients with paediatric onset mucopolysaccharidosis II (MPS II) since the commercial introduction of enzyme replacement therapy (ERT) in England in 2007 is reported. Median length of follow up was 10 years 3 months (range = 1 y 2 m to 18 years 6 month). 78 patients were treated with ERT, 18 had no ERT or disease modifying treatment 7 had haematopoietic stem cell transplant, 4 experimental intrathecal therapy and 3 were lost to follow up. Read More

Eur J Intern Med 2019 09 30;67:1-13. Epub 2019 Jul 30.

Onassis Cardiac Surgery Center, Athens, Greece.

Cardiac amyloidosis or amyloid cardiomyopathy (ACM), commonly resulting from extracellular deposition of amyloid fibrils consisted of misfolded immunoglobulin light chain (AL) or transthyretin (TTR) protein, is an underestimated cause of heart failure and cardiac arrhythmias. Among the three types of cardiac amyloidosis (wild-type or familial TTR and light-chain), the wild-type (Wt) TTR-related amyloidosis (ATTR) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF), and amyloidosis should be considered in the differential diagnosis of this heart failure group of patients. Recent advances in the diagnosis and drug treatment of ACM have ushered in a new era in early disease detection and better management of these patients. Read More

World Neurosurg 2019 Nov 29;131:104-107. Epub 2019 Jul 29.

Department of Neurological Surgery, Tufts Medical Center at Boston, Boston, Massachusetts, USA. Electronic address:

Background: Transthyretin wild-type (ATTRwt) amyloidosis is a systemic process resulting in deposition of misfolded transthyretin protein in several different tissues throughout the body. It is known to be a cause of progressive, life-threatening cardiomyopathy and lumbar spinal stenosis and carpal tunnel syndrome.

Case Description: Here we present the case of a 71-year-old man who has clinical manifestations of all 3 entities over several years, providing a picture of the natural history of ATTRwt amyloidosis. Read More

Muscle Nerve 2019 11 9;60(5):538-543. Epub 2019 Aug 9.

East Kent Hospitals University NHS Foundation Trust, Kent and Canterbury Hospital, Canterbury, Kent, United Kingdom.

Introduction: Therapeutic ultrasound has been suggested as a treatment for carpal tunnel syndrome (CTS), but existing trial evidence is of poor quality and inconclusive.

Methods: We conducted a randomized, controlled trial of therapeutic ultrasound in mild to moderate CTS. Forty patients were treated with wrist splints plus either real or sham therapeutic ultrasound and followed for 1 year posttreatment. Read More

Radiol Clin North Am 2019 Sep 5;57(5):1063-1071. Epub 2019 Jun 5.

Department of Radiology, Division of Musculoskeletal Radiology, University of Michigan Hospital, Main Campus, 1500 East Medical Center Drive, Taubman Center 2910L, Ann Arbor, MI 48109-5326, USA.

Peripheral neuropathy (often defined as weakness of sensory loss in one limb) of the upper extremity is a common clinical musculoskeletal scenario. The most common include carpal tunnel syndrome, cubital tunnel syndrome, and cervical radiculopathy. A combination of clinical examination, electrodiagnostic testing, and imaging studies, chiefly MR imaging and ultrasonography, is often needed to identify a specific diagnosis for an individual patient. Read More

Hand (N Y) 2019 Jul 23:1558944719861711. Epub 2019 Jul 23.

1 University of Manitoba, Winnipeg, Canada.

Endoscopic carpal tunnel release (ECTR) has purported advantages over open release such as reduced intraoperative dissection and trauma and more rapid recovery. Endoscopic carpal tunnel release has been shown to have comparable outcomes to open release, but open release is considered easier and safer to perform. Previous studies have demonstrated an increase in carpal tunnel volume, regardless of the technique used. Read More

Ned Tijdschr Geneeskd 2019 07 12;163. Epub 2019 Jul 12.

Medisch Centrum Leeuwarden, afd. Plastische Chirurgie, Leeuwarden.

A 57-year-old woman presented herself in the plastic surgery department's outpatient clinic at our hospital. She had been experiencing a tingling sensation of the first three digits of the left hand. Our first differential diagnosis was a classic carpal tunnel syndrome. Read More

BMC Med Imaging 2019 07 4;19(1):52. Epub 2019 Jul 4.

Department of Physical Medicine and Rehabilitation Taipei Tzuchi Hospital, Buddhist Tzuchi Medical Foundation, No.289, Jianguo Rd., Xindian Dist, New Taipei City, 231, Taiwan, Republic of China.

Background: To evaluate the diagnostic accuracy of the median-to-ulnar nerve ratio (MUR) and the median-to-ulnar nerve difference (MUD) in patients with carpal tunnel syndrome (CTS).

Methods: In this study, 32 patients with CTS and 32 healthy volunteers were evaluated. All participants received a series of tests and ultrasound examination for the evaluation of the following criteria: cross-sectional area of the median nerve at the pisiform level (CSA-P), swelling ratio (SR), MUR, MUD, and flattening ratio (FR). Read More

Muscle Nerve 2019 11 16;60(5):501-512. Epub 2019 Jul 16.

St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia.

Peripheral nerve disorders are commonly encountered in clinical practice. Electrodiagnostic studies remain the cornerstone of the evaluation of nerve disorders. More recently, ultrasound has played an increasing complementary role in the neuromuscular clinic. Read More

Arch Gynecol Obstet 2019 09 2;300(3):623-631. Epub 2019 Jul 2.

Department of Public Health, Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Programa de Pós-Graduação Em Saúde Coletiva, Av. Prof. Mário Rubens Guimarães Montenegro, s/n. Bairro: UNESP, Campus de Botucatu, Botucatu, São Paulo, CEP: 8618687, Brazil.

Purpose: To estimate the prevalence of indicative signs and symptoms of carpal tunnel syndrome (CTS) during the third trimester of pregnancy; assess the severity of symptoms and functional impairment; evaluate associated factors; and to evaluate the complaint of CTS in pregnant women through ultrasonography (USG).

Methods: A cross-sectional study, in which participants were classified into two groups: presence and absence of indicative signs and symptoms of CTS. Severity of symptoms and functional status was assessed by the Boston Carpal Tunnel Questionnaire. Read More

Medicine (Baltimore) 2019 Jun;98(26):e16039

Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital.

This study aimed to investigate the relationship between the change of median nerve cross-sectional area (CSA) and the severity of carpal tunnel syndrome (CTS) determined by electrodiagnostic study based on the area immediately proximal to the carpal tunnel inlet (IPCTI).From December 2016 to August 2017, 34 patients (8 men and 26 women; mean age, 61.68 years ± 11. Read More