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Brain Res 2021 Jun 8:147558. Epub 2021 Jun 8.

School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. Electronic address:

Functional and structural brain alterations have been noted in carpal tunnel syndrome (CTS), the most common entrapment peripheral neuropathy. Previous studies were mainly focused on somatosensory cortices. However, the changes of white matter diffusion properties in nonsensorimotor cortices remain uninvestigated. Read More

J Wrist Surg 2021 Jun 3;10(3):196-200. Epub 2021 Jan 3.

Departments of Orthopaedic Surgery and Radiology, School of Medicine, New York University, New York.

 The etiology of carpal tunnel syndrome (CTS) is multifactorial. Static mechanical characteristics of CTS have been described, but dynamic (muscular) parameters remain obscure. We believe that musculature overlying the transverse carpal ligament may have an effect on carpal tunnel pressure and may explain the prevalence of CTS in manual workers. Read More

Cardiol Ther 2021 Jun 4. Epub 2021 Jun 4.

Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Amyloidosis caused by systemic deposition of transthyretin (TTR) is called ATTR amyloidosis and mainly includes hereditary ATTR (ATTRv) amyloidosis and wild-type ATTR (ATTRwt) amyloidosis. Until recently, ATTRv amyloidosis had been considered a disease in the field of neurology because neuropathic symptoms predominated in patients described in early reports, whereas advances in diagnostic techniques and increased recognition of this disease revealed the presence of patients with cardiomyopathy as a predominant feature. In contrast, ATTRwt amyloidosis has been considered a disease in the field of cardiology. Read More

Diagnostics (Basel) 2021 May 9;11(5). Epub 2021 May 9.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan.

This study aimed to investigate the effect of different injectate volumes on ultrasonographic parameters and the correlation to clinical outcomes under perineural dextrose injection (PDI). In this post hoc analysis of the randomized, double-blinded, three-arm trial, ultrasound-guided PDI with either 1 mL, 2 mL, and 4 mL 5% dextrose water was administered, respectively, in 14, 14, and 17 patients. Ultrasound outcomes included mobility, shear-wave elastography (SWE), and cross-sectional area (CSA) of the median nerve; clinical outcomes were Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) score. Read More

JBJS Essent Surg Tech 2020 Oct-Dec;10(4). Epub 2020 Nov 19.

Texas Children's Hospital, Houston, Texas.

Background: Sedated, closed reduction of a displaced distal radial fracture followed by cast immobilization is indicated in cases of unacceptable alignment on post-splint imaging. The aim of this procedure is to obtain acceptable reduction and cast immobilization for fracture-healing.

Description: The patient is positioned supine with the injured arm on the image intensifier. Read More

Orthop J Sports Med 2021 May 13;9(5):23259671211007734. Epub 2021 May 13.

Department of Radiology, School of Medicine, Gyeongsang National University, and Gyeongsang National University Hospital, Jinju, Republic of Korea.

Background: Metabolic factors have been linked to tendinopathies, yet few studies have investigated the association between metabolic factors and lateral epicondylitis.

Purpose: To evaluate risk factors for lateral epicondylitis, including several metabolic factors.

Study Design: Case-control study; Level of evidence, 3. Read More

BMC Musculoskelet Disord 2021 May 24;22(1):477. Epub 2021 May 24.

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

Background: Reduced gliding ability of the median nerve in the carpal tunnel has been observed in patients with carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the gliding abilities of the median nerve and flexor tendon in patients with CTS and healthy participants in the neutral and 30° extended positions of the wrist and to compare the gliding between the finger flexion and extension phases.

Methods: Patients with CTS and healthy participants were consecutively recruited in a community hospital. Read More

J Chiropr Med 2021 Mar 12;20(1):30-36. Epub 2021 May 12.

Chiropractic Department, D'Youville College, Buffalo, New York.

Objective: This purpose of this case report is to describe the chiropractic management of a patient who presented with symptoms of hand neuropathy.

Clinical Features: A 35-year-old woman presented with a 6-month history of numbness and tingling in the first and second digits of the right hand. Visual inspection revealed a large golf ball-like mass in the patient's right lower neck region. Read More

Cureus 2021 Apr 18;13(4):e14546. Epub 2021 Apr 18.

Department of Orthopedic Surgery, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

Amyloidosis is a group of disorders that occurs due to the aggregation of insoluble and misfolded proteins in the extracellular space, eventually resulting in organ dysfunction. Type II amyloidosis is caused by the deposition of transthyretin (TTR), which will be the main focus of this article. Deposition of TTR in the myocardium results in a restrictive form of cardiomyopathy. Read More

Medicine (Baltimore) 2021 May;100(20):e25872

Department of Plastic Surgery, Korea University College of Medicine, Seoul, South Korea.

Rationale: Despite significant advances in microsurgical techniques, simultaneous release of transverse carpal ligament (TCL) and lymphovenous anastomosis (LVA) surgeries may be effective for treatment of carpal tunnel syndrome (CTS) and advanced-stage lymphedema. This case report describes the successful treatment of lymphedema with LVA in a patient with CTS and advanced-stage lymphedema.

Patient Concerns: A 60-year-old female patient was referred to our lymphedema clinic with a 12-year history of chronic, acquired, right upper extremity lymphedema and CTS following right mastectomy and axillary lymph node dissection and adjuvant chemoradiotherapy for treating breast cancer. Read More

Korean J Radiol 2021 May 4. Epub 2021 May 4.

Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

Objective: To investigate changes in the median nerve, retinaculum, and carpal tunnel on ultrasound after successful endoscopic carpal tunnel release (ECTR).

Materials And Methods: This prospective study involved 37 wrists in 35 patients (5 male, 30 female; mean age ± standard deviation [SD], 56.9 ± 6. Read More

Plast Reconstr Surg 2021 Jun;147(6):1355-1360

From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Division of Hand Surgery, and the Radiology Department, Selcuk University Medical Faculty.

Background: The objectivity of physical and electrodiagnostic tests is limited in detecting carpal tunnel syndrome and its recurrence. Predicting the median nerve blood supply using superb microvascular imaging will allow exact diagnosis and a good follow-up system. The aims of this study include using superb microvascular imaging to correlate with electromyographic diagnosis, and to determine the impact of surgery on improvement in superb microvascular imaging. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):223-228

Department of Orthopedic Surgery, Goto Orthopedic Hand Clinic, Sendai, Japan.

Ultrasonographically measuring the median nerve cross-sectional area (MN-CSA) is a useful and complementary method for diagnosing carpal tunnel syndrome (CTS). This study investigated the usefulness of the median nerve transverse diameter (MN-TD) as a simpler and easier technique than MN-CSA for diagnosing CTS severity. We examined 145 hands from 101 patients with CTS and 114 age- and gender-matched control hands. Read More

J Neurol Surg A Cent Eur Neurosurg 2021 Apr 12. Epub 2021 Apr 12.

Department of Neurology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Veneto, Italy.

Our case report underscores the importance of electroneuromyography (ENMG) combined with peripheral nerve high-resolution ultrasound (HRUS) in the evaluation of neurofibromatosis type 1 (NF1). A 49-year-old woman affected by NF1 came to our attention because of new-onset left arm weakness and atrophy. Debulking of a cervicothoracic C7-T1 neurofibroma had been performed 8 years earlier. Read More

Tohoku J Exp Med 2021 04;253(4):241-248

Department of Nephrology, Kamome Clinic.

Dialysis-related amyloidosis (DRA) is characterized by the deposition of amyloid consisting of beta2-microglobulin in the musculoskeletal system, causing carpal tunnel syndrome, destructive spondyloarthropathy, and/or bone cysts. Increased cystic radiolucency of the bones and tendon thickening due to inflammation are common findings in DRA. We have developed a new dialysis method, extended-hours hemodialysis without dietary restrictions for the aim of improving both hypertension and malnutrition. Read More

Int J Occup Med Environ Health 2021 Mar 30. Epub 2021 Mar 30.

Chosun University Hospital, Gwang-ju, Republic of Korea (Department of Occupational and Environmental Medicine).

Objectives: This study aimed to investigate the prevalence of musculoskeletal disorders in the hands and wrists of fishermen working as oyster shuckers, and to identify the risk factors associated with oyster shucking.

Material And Methods: A total of 590 fishery workers including those working as oyster shuckers in 2015-2017 were included in the study analysis. Hand osteoarthritis (OA), carpal tunnel syndrome (CTS), and ulnar impaction syndrome were diagnosed using X-ray, magnetic resonance imaging, and physical examinations according to each diagnostic criterion. Read More

Indian J Radiol Imaging 2020 Oct-Dec;30(4):510-512. Epub 2021 Jan 13.

Department of Radio-Diagnosis and Imaging, PGIMER, Chandigarh, India.

Perineural cysts are usually described in Lumbosacral region and are uncommonly seen in cervical spine. These are mostly asymptomatic, with only a few cases of symptomatic cervical perineural cysts. No previous case report of perineural cyst causing C8/T1 radiculoneuropathy mimicking clinically as Carpal tunnel syndrome is reported in the literature. Read More

J Pain Res 2021 11;14:693-701. Epub 2021 Mar 11.

School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.

Introduction: Numerous resting-state functional magnetic resonance imaging (fMRI) researches have indicated that large-scale functional and structural remodeling occurs in the whole brain despite an intact sensorimotor network after carpal tunnel syndrome (CTS). Investigators aimed to explore alterations of the global and nodal properties that occur in the whole brain network of patients with CTS based on topographic theory.

Methods: Standard-compliant fMRI data were collected from 27 patients with CTS in bilateral hands and 19 healthy control subjects in this cross-sectional study. Read More

J Hand Surg Am 2021 Mar 13. Epub 2021 Mar 13.

HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ.

A persistent median artery is a rare anatomical variant found in approximately 10% of the population. Carpal tunnel syndrome due to a thrombosed persistent median artery is exceptionally rare. A 29-year-old professional hockey player presented with a 2 months history of hand pain and intermittent paresthesias without vascular symptoms. Read More

Turk J Med Sci 2021 Mar 12. Epub 2021 Mar 12.

Background/aim: Carpal tunnel is an important anatomical passage that carries the flexor tendons into the hand. As there is still no consensus about its contents among the anatomy textbooks, the main purpose of this study was to identify the relations of the flexor carpi radialis tendon in the carpal tunnel.

Materials And Methods: This retrospective study was completed in April 2018 at authors? university?s hospital. Read More

Medicine (Baltimore) 2021 Mar;100(9):e24575

Orthopedics Department, First Affiliated Hospital of Dalian Medical University, Dalian, China.

Background: Sonography enhances diagnostic accuracy by the detection of the epineural or intraneuronal blood flow.[1-4] Power Doppler ultrasonography (PDUS) in carpal tunnel syndrome (CTS) has been previously studied and shown to be valid and reliable for grading the intraneural flow.[3,4] However, superb microvascular imaging (SMI) represents a new era in diagnostic sonography, and this new technology enables accurate visualization of vascular structures with intensive clutter suppression to provide flow signals for large to small vessels, and it presents these data at high frame rates. Read More

Radiologe 2021 Apr 1;61(4):375-381. Epub 2021 Mar 1.

Abteilung für Neuroradiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

Background: Peripheral nerve disorders of the hand and wrist are most commonly caused by entrapment neuropathies, while traumatic nerve injuries and neoplasms are less common.

Objectives: The indication for additional imaging methods and different imaging options, especially in patients with atypical symptoms or remaining unclear etiology of symptoms after completion of standard diagnostics, are presented.

Materials And Methods: The imaging methods magnetic resonance (MR) neurography and neurosonography are introduced, and typical findings as well as diagnostic pitfalls are presented. Read More

Eur Heart J Case Rep 2020 Dec 6;4(6):1-6. Epub 2020 Nov 6.

Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, chuo-ku, Kumamoto, Kumamoto 860-8556, Japan.

Background: Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is receiving increasing attention due to the availability of novel treatment options. Carpal tunnel syndrome (CTS) and lumbar spinal canal stenosis are known early symptoms of transthyretin (TTR) amyloidosis preceding the cardiac involvement and are considered as 'Red Flags' for transthyretin amyloid cardiomyopathy (ATTR-CM).

Case Summary: A 67-year-old man with a history of lumbar spinal canal stenosis for the last 10 years, right rotator cuff tears for the last 4 years, and bilateral CTS for the last 1 year was scheduled for orthopaedic surgery for lumbar spinal canal stenosis. Read More

Muscle Nerve 2021 05 23;63(5):774-777. Epub 2021 Feb 23.

Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Japan.

Introduction: We investigated the changes in MRI T2 mapping values in subjects with carpal tunnel syndrome (CTS) compared to healthy controls.

Methods: We enrolled 71 patients with CTS and 26 healthy controls. Median nerve T2 values were measured at the distal carpal tunnel, hamate bone, proximal carpal tunnel, and forearm levels. Read More

J Hand Surg Asian Pac Vol 2021 Mar;26(1):96-99

Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Carpal tunnel syndrome (CTS) is the most common type of entrapment neuropathy. The majority of CTS cases are idiopathic and affect females between 40 and 60 years old. Conversely, this report describes two female patients in their mid-30's diagnosed with CTS caused by a median artery in the carpal tunnel using ultrasonography. Read More

Muscle Nerve 2021 05 15;63(5):E44-E46. Epub 2021 Feb 15.

Departments of Orthopedic Surgery and Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.

Curr Med Imaging 2021 Jan 28. Epub 2021 Jan 28.

Physiatry and Electrodiagnosis Research Center (CIFEL). Colombia.

Background: Ultrasonography is a diagnostic resource that serves as a complement in the evaluation of patients with carpal tunnel syndrome. The correlation of ultrasonography findings with nerve conduction studies can serve to classify new phenotypes and to evaluate therapeutic responses.

Objectives: To determine the diagnostic sensitivity of ultrasound, the correlation between the cross-sectional area against the motor and sensitive latencies, and the capacity to differentiate the mild, moderate and severe degrees of the electrophysiological classification of carpal tunnel syndrome. Read More

BMC Musculoskelet Disord 2021 Jan 26;22(1):112. Epub 2021 Jan 26.

Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou, 362000, Fujian, China.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves. High-frequency ultrasound (HFUS) is widely used in the diagnosis of CTS. Virtual Touch Tissue Imaging and Quantification (VTIQ), which provides more information about the hardness of organization, is used to diagnose CTS. Read More

Hand (N Y) 2021 Jan 24:1558944720988075. Epub 2021 Jan 24.

Lahey Hospital and Medical Center, Burlington, MA, USA.

Background: High-resolution ultrasound (HRU) has demonstrated utility in the diagnosis and treatment of carpal tunnel syndrome (CTS) by measuring the cross-sectional area (CSA) of the median nerve. We investigated whether HRU could be helpful in evaluating outcomes of carpal tunnel release in patients with severe CTS.

Methods: Patients greater than 18 years of age with severe CTS on electrodiagnostic (EDX) studies and scheduled to have carpal tunnel release were enrolled. Read More