Search Our Scientific Publications & Authors

J Am Acad Orthop Surg 2019 Apr 9. Epub 2019 Apr 9.

From the Department of Orthopaedic Surgery (Dr. Lauder, Dr. Mithani, and Dr. Leversedge), and the Department of Surgery (Dr. Mithani and Dr. Leversedge), Division of Plastic Surgery, Duke University Medical Center, Durham, NC.

Recalcitrant carpal tunnel syndrome presents a clinical challenge. Potential etiologies of persistent or recurrent symptoms after primary carpal tunnel release include incomplete nerve decompression, secondary sites of nerve compression, unrecognized anatomic variations, irreversible nerve pathology associated with chronic compression neuropathy, perineural adhesions, conditions associated with secondary nerve compression, iatrogenic nerve injury, or inaccurate preoperative diagnosis. Understanding the pertinent surgical anatomy and pathophysiology is essential toward developing an effective diagnostic and treatment strategy. Read More

BMC Musculoskelet Disord 2019 Apr 9;20(1):157. Epub 2019 Apr 9.

The First Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an Shaanxi, 710004, People's Republic of China.

Background: Endoscopic carpal tunnel release (ECTR) has been gradually adopted for the treatment of severe carpal tunnel syndrome (CTS). However, perioperative assessment of neuroanatomical parameters of median nerve, which are important determinant of median nerve recovery, has rarely been reported. This one-year prospective study aimed to investigate the natural history of the neuroanatomical morphology of the median nerve after ECTR in severe CTS patients by high-frequency ultrasonography and assess the ability of neuroanatomical measures to quantify morphological recovery of the median nerve after ECTR. Read More

J Orthop Surg Res 2019 Mar 28;14(1):91. Epub 2019 Mar 28.

Department of Orthopedic Surgery, Tsuchiya General Hospital, Hiroshima, Japan.

Background: Carpal tunnel syndrome (CTS) is common among patients receiving hemodialysis and deeply influences their daily life. Amyloid deposits are considered the main reason for median nerve compression, but its prevalence is unclear. Therefore, to determine the main region of amyloid deposition inside the carpal tunnel, we measured the cross-sectional area (CSA) of each component of the carpal tunnel in preoperative magnetic resonance imaging (MRI). Read More

J Neurol 2019 Feb 25. Epub 2019 Feb 25.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Background: High-resolution ultrasound (US) becomes a reliable tool for diagnosing carpal tunnel syndrome (CTS), but whether it can be applied to patients with preexisting diabetes mellitus (DM) remains unclear.

Methods: We searched PubMed and Embase and systemically reviewed studies exploring the median nerve CSAs at the wrist level by US imaging. Nine studies enrolling at least one subgroup comprising patients with both DM and CTS were included for network meta-analysis. Read More

J Biomech 2019 Mar 21;85:141-147. Epub 2019 Jan 21.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States. Electronic address:

Inhibited movement patterns of carpal tunnel structures have been found in carpal tunnel syndrome (CTS) patients. Motion analysis on ultrasound images allows us to non-invasively study the (relative) movement of carpal tunnel structures and recently a speckle tracking method using singular value decomposition (SVD) has been proposed to optimize this tracking. This study aims to assess the reliability of longitudinal speckle tracking with SVD in both healthy volunteers and patients with CTS. Read More

J Vis Exp 2019 Jan 11(143). Epub 2019 Jan 11.

Department of Orthopedics & Traumatology, The University of Hong Kong;

Axonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current diagnostic and severity gradation system cannot clearly indicate its coexistence, resulting in confusion of appropriate treatment prescription. There are also constraints in conventional methods for differentiation as well. Read More

Cureus 2018 Oct 23;10(10):e3487. Epub 2018 Oct 23.

Anatomy, Histology and Embryology, Medical University of Sofia, Sofia, BGR.

The use of medical ultrasound as an imaging modality in the evaluation of the carpal tunnel syndrome has been growing. Technical progress and the introduction of new, high-quality devices and ultra-high frequency transducers with smaller dimensions have led to a better quality of acquired images and the development of new examination methodologies. The sonographic method has a number of advantages: available, non-invasive, cheaper, and allows an easier and faster evaluation and diagnosis of carpal tunnel syndrome, along with the possibility to assess various parameters of the median nerve, including its size, blood flow, and mobility. Read More

J Clin Ultrasound 2019 Mar 29;47(3):122-127. Epub 2018 Dec 29.

Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Shatin, NT, Hong Kong.

Background: This study compares median nerve cross-sectional area (CSA) measurements at the wrist obtained with ultrasound (US) and magnetic resonance imaging (MRI) using cadaveric measurements as the gold standard.

Methods: Median nerve CSA was measured using US and MRI in 9 cadaveric wrists obtained from 5 subjects at 5 locations: distal forearm, proximal to tunnel inlet, at tunnel inlet, at tunnel outlet, and distal to tunnel outlet and then on identical cadaveric transverse sections obtained with a bandsaw. All US, MRI, and cadaveric measurements were repeated to determine reliability. Read More

Medicine (Baltimore) 2018 Dec;97(52):e13943

Department of Rehabilitation Medicine.

Rationale: Carpal tunnel syndrome (CTS) is the most common peripheral nerve neuropathy resulting from compression of the median nerve as it traverses the carpal tunnel. The pathophysiology of this condition is multifactorial, and majority of cases of CTS are idiopathic. We report cases of CTS caused by synovial osteochondromatosis (SOC), which has rarely been reported. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2018;118(11):30-34

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow StateMedical University of the Ministry of Health of the Russian Federation, Moscow, Russia.

Aim: An analysis of typical medical errors in the diagnosis and treatment of compression neuropathy of the median nerve at the level of the wrist (carpal tunnel syndrome - CTS).

Material And Methods: Previous diagnoses and treatment of 85 patients with CTS (14 men and 71 women), aged from 36 to 84 years (middle age 62±10.6 years), who underwent surgery in our clinics were evaluated. Read More

J Hand Surg Am 2019 Feb 20;44(2):85-92.e1. Epub 2018 Dec 20.

Veterans Affairs Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA; Department of Surgery, Stanford University, Palo Alto, CA.

Purpose: To evaluate facility-level variation in the use of services for patients with carpal tunnel syndrome (CTS) receiving care in the Veterans Health Administration (VHA).

Methods: A national cohort of VHA patients diagnosed with CTS during fiscal year 2013 was divided into nonsurgical and operative treatment groups for comparison. We assessed the use of 5 types of CTS-related services (electrodiagnostic studies [EDS], imaging, steroid injection, oral steroids, and therapeutic modalities) in the prediagnosis and postdiagnosis periods before any operative intervention at the patient and facility levels. Read More

J Med Case Rep 2018 Dec 16;12(1):370. Epub 2018 Dec 16.

Department of Clinical Research, Chiba Tokushukai Hospital, Chiba, Japan.

Background: Transthyretin amyloidosis is a systemic disorder caused by extracellular deposition of insoluble amyloid fibrils in peripheral and autonomic nerves, heart, kidney, gastrointestinal tract, and other organs. Hereditary transthyretin amyloidosis is an autosomal dominant disease. More than 120 mutations have been reported in the transthyretin gene with considerable phenotypic heterogeneity and geographic diversity. Read More

Acta Ortop Mex 2018 Jul-Aug;32(4):209-213

Unidad Médica de Alta Especialidad de Traumatología y Ortopedia «Lomas Verdes» del Instituto Mexicano del Seguro Social (IMSS). México.

Introduction: Carpal tunnel syndrome is the most common compression neuropathy of the upper limb, and the release of the median nerve is the surgical treatment that is carried out. There are several surgical techniques used to treat this condition; However, this virtual cavity, which we call the carpal tunnel, undergoes several morphological and dimensional changes, prior to surgery and after surgery using the various techniques that the surgeon has a predilection for.

Material And Methods: Observational, prospective and longitudinal study conducted in the period from March to November 2009. Read More

Clin Dysmorphol 2019 Jan;28(1):7-16

Greenwood Genetic Center, Greenwood, South Carolina.

Mucolipidosis-IIIγ (ML-IIIγ) is a recessively inherited slowly progressive skeletal dysplasia caused by mutations in GNPTG. We report the genetic and clinical findings in the largest cohort with ML-IIIγ so far: 18 affected individuals from 12 families including 12 patients from India, five from Turkey, and one from the USA. With consanguinity confirmed in eight of 12 families, molecular characterization showed that all affected patients had homozygous pathogenic GNPTG genotypes, underscoring the rarity of the disorder. Read More

Am J Case Rep 2018 Nov 24;19:1398-1404. Epub 2018 Nov 24.

Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.

BACKGROUND Amyloid arthropathy and myopathy are complications of amyloidosis that can be associated with non-specific imaging findings, which may be challenging to interpret. The report is of a case of polyarticular amyloid arthropathy and myopathy in a 56-year-old man with multiple myeloma and includes a description of the radiographic, computed tomography (CT), and magnetic resonance imaging (MRI) findings. CASE REPORT A 56-year-old man with multiple myeloma presented with chronic polyarticular pain and swelling. Read More

J Orthop Surg Res 2018 Nov 16;13(1):288. Epub 2018 Nov 16.

Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-4-5, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

Background: Thumb opposition is vital for hand function and involves pronation and palmar abduction. The improvement of pronation is often used as one of the evaluation items of the opponensplasty method for severe carpal tunnel syndrome. However, most of the studies used substitution evaluation methods for measurement of the pronation angle. Read More

J Hand Surg Asian Pac Vol 2018 Dec;23(4):589-592

1 Department of Orthopedic Surgery, Hokkaido Saiseikai Otaru Hospital, Otaru, Japan.

We experienced a rare case of carpal tunnel syndrome and rupture of the flexor digitorum profundus tendon to the index finger with a scapholunate advanced collapse wrist. We speculated that the lunate that had extruded into the carpal tunnel compressed the median nerve and caused wear of the flexor tendon following neglected perilunate subluxation. Carpal tunnel release, opponensplasty by palmaris longus tendon transfer, and a bridge graft by a half-slip of the flexor carpi radialis tendon resulted in recovery of pinch function and improvement in numbness of the hand. Read More

J Hand Surg Asian Pac Vol 2018 Dec;23(4):528-532

* Department of Physical Medicine and Rehabilitation, Uludag University School of Medicine, Bursa, Turkey.

Background: The purpose of this study was to investigate the relationship between anthropometric hand/wrist measurements and outcomes following static wrist splintage in patients with mild-to-moderate carpal tunnel syndrome (CTS).

Methods: Thirty nine patients with mild-to-moderate CTS were enrolled in this study. Anthropometric measurements of hand and wrist including wrist width, wrist depth, palm length, hand length, wrist ratio (wrist depth/wrist width) and wrist/palm ratio (wrist depth/palm length) were recorded as well as body mass index and ultrasonographic cross sectional area of median nerve. Read More

Agri 2018 Oct;30(4):206-208

Department of Neurology, Sakarya University Training and Reserach Hospital, Sakarya, Turkey.

Fahr disease is an idiopathic disorder characterized with deposition of calcium and a few other minerals in basal ganglia, cerebellum and subcortical brain area. A 51 years old female with the complaints of pain, numbness, tingling and weakness in both upper extremities for six months was referred to our electromyography laboratory with a suspicion of carpal tunnel syndrome. She got the diagnosis of Fahr disease upon the investigations for the convulsions that she experienced ten years ago. Read More

J Diagn Med Sonogr 2019 01 20;35(1):62-68. Epub 2018 Oct 20.

Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA.

Musculoskeletal sonography is being widely used for evaluation of structures within the carpal tunnel. While some anatomical variants, such as bifurcated median nerves and persistent median arteries, have been well documented, limited literature describes the sonographic appearance of aberrant muscle bellies within the carpal tunnel. Multiple examples of the sonographic appearance of flexor digitorum superficialis and lumbrical muscle bellies extending into the carpal tunnel are provided. Read More

Eur J Radiol 2018 Nov 24;108:172-176. Epub 2018 Sep 24.

Marmara University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey. Electronic address:

Purpose: To evaluate if there is a place for ultrasonography (US) and ultrasonographic elastography (UE) in the diagnosis and follow up of carpal tunnel syndrome treatment.

Materials And Methods: The study was performed on 25 patients (study group) and 17 healthy volunteers (control group). Measured US and UE criteria were median nerve area (MNA), proximal median nerve area (pMNA), difference between MNA and pMNA (dMNA) and strain values of carpal tunnel content (CTC) and median nerve (MN). Read More

Turk J Med Sci 2018 Oct 31;48(5):925-932. Epub 2018 Oct 31.

Background and aim: This study aims to ultrasonographically and clinically evaluate the additive contribution of kinesiotaping to tendon and nerve gliding exercises in the treatment of mild or moderate carpal tunnel syndrome (CTS). Materials and methods: Thirty-eight wrists of patients (n = 21) with CTS were randomized into two groups as the intervention group (n = 19) and the control group (n = 19). Tendon and nerve gliding exercises were given to both groups. Read More

Eklem Hastalik Cerrahisi 2018 Dec;29(3):165-9

Department of Orthopedics and Traumatology, Selçuk University Medical Faculty, 42130 Selçuklu, Konya, Turkey.

Objectives: This study aims to evaluate the distance between the median nerve and the hook of the hamate pre- and postoperatively in patients with carpal tunnel syndrome and to investigate the efficiency of magnetic resonance imaging in diagnosis and postoperative follow-up.

Patients And Methods: Median nerve decompression was performed by releasing the carpal tunnel in 15 patients (4 males, 11 females; mean age 51 years; range, 41 to 66 years) with carpal tunnel syndrome. The shortest distance between the median nerve and the hook of the hamate was measured with magnetic resonance imaging preoperatively and at three months after the operation and radial and ulnar translations were assessed. Read More

Clin Interv Aging 2018 11;13:1953-1962. Epub 2018 Oct 11.

Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden,

Background: Accurate diagnosis of carpal tunnel syndrome (CTS), the most common entrapment neuropathy, and its differentiation from other diseases are essential, especially in older individuals with advanced symptoms and modified electrophysiological abnormalities. The current study was conducted to evaluate the diagnostic accuracy of ultrasonography (US), regarding sensitivity and specificity in the diagnosis of CTS in elderly patients.

Methods: Individuals with upper limb complaints and reference subjects were recruited from the Rofaydeh Hospital, Tehran, Iran, from June 2013 to October 2014 - (15 months). Read More

Skeletal Radiol 2018 Oct 20. Epub 2018 Oct 20.

Dipartimento di Neurochirurgia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.

Macrodystrophia lipomatosa, a hamartomatous enlargement of soft tissues leading to gigantism of a part or a whole extremity, generally affects the territory of distribution of a single nerve. In some cases, this condition may cause an entrapment neuropathy. We report the clinical, radiological, and surgical findings of a patient with isolated non-syndromic macrodactyly and giant median nerve presenting recurrent carpal tunnel syndrome (CTS). Read More

J Biol Regul Homeost Agents 2018 Sep-Oct;32(5):1285-1290

Department of Sensory Organs "Sapienza" University of Rome, Italy.

Three cases of anatomical variation of the median nerve at the wrist found during our surgical activity led us to take the opportunity to expose anatomical variations by reviewing already published reviews. Consequently, on the basis of anatomical studies, clinical reports and imaging, as a result of careful examination of the published literature, it has been observed that the interventions in such anatomical area must take into account these variations. In particular, the most performed procedure is the lysis of the transverse carpal ligament (TCL), which is not free from complications. Read More

Clin Radiol 2018 Dec 9;73(12):1058.e11-1058.e19. Epub 2018 Oct 9.

Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City 637000, Sichuan Province, China. Electronic address:

Aim: To assess the diagnostic value of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of diffusion tensor imaging (DTI) at several anatomical locations in patients with carpal tunnel syndrome (CTS) to explore the optimal parameters and measurement location.

Materials And Methods: A search was conducted using the PubMed, EBSCO, Ovid, Web of Science, and Cochrane databases to identify articles relevant to this study published before September 2017. Studies were selected and included according to strict eligibility criteria. Read More

Pathologe 2018 Dec;39(Suppl 2):301-305

Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität Kiel, Arnold-Heller-Straße 3/14, 24105, Kiel, Deutschland.

Amyloid is a pathologic fibrillar aggregation of polypeptides in a cross-β-sheet conformation. Amyloidoses are caused by the deposition of amyloid and may occur as cerebal and extracerebral diseases. A total of 35 different amyloid proteins have been identified. Read More

Ann Plast Surg 2019 Jan;82(1):76-81

From the Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea.

Purpose: We evaluated the relationship between the area around the distal radioulnar joint according to the ulnar variances and the cross-sectional area using magnetic resonance imaging (MRI) scans in this prospective study of patients with carpal tunnel syndrome (CTS).

Methods: From among a total of 243 patients who had been diagnosed with CTS between March 2012 and February 2017 at our hospital, 41 patients with positive ulnar variance were enrolled in group 1. As control groups, 39 healthy volunteers who underwent MRI evaluations were included in group 2 (neutral ulnar variance) and group 3 (negative variance). Read More

J Hand Surg Am 2018 Sep 18. Epub 2018 Sep 18.

Department of Orthopedic Surgery, Hospital for Special Surgery, New York.

Purpose: The purpose of this study was to identify associations between the clinical manifestations of carpal tunnel syndrome (CTS) and the sonographic measurements of the median nerve in the carpal tunnel. We hypothesized that sonographic changes in the median nerve from proximal to distal along the carpal tunnel would be associated with symptom severity scores.

Methods: We report on 38 patients with clinical signs and symptoms of CTS in a prospective investigation. Read More

J Back Musculoskelet Rehabil 2018 ;31(5):981-989

Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey.

Background: Clinical and electrophysiological effects of therapeutic ultrasound (US) were researched in many studies on patients with CTS with conflicting results.

Objective: To assess the effects of continuous and pulsed US treatments by ultrasonographic imaging in addition to clinical and electrophysilogical parameters in patients with carpal tunnel syndrome (CTS).

Method: Fifty-four patients with idiopathic CTS were randomly divided into three groups. Read More

J Am Acad Orthop Surg 2019 Jan;27(1):e17-e23

From the Department of Orthopedic Surgery (Dr. Ting, Dr. Blazar, Dr. Collins, Ms. Mora, and Dr. Earp), and the Department of Neurology (Dr. Salajegheh and Dr. Amato), Brigham and Women's Hospital, Boston, MA.

Introduction: The purpose of this study was to assess whether median nerve ultrasonography (US) measurements correlate with the severity scale of electrodiagnostic studies (EDS) of carpal tunnel syndrome (CTS).

Methods: A retrospective review was conducted of patients aged ≥18 years who underwent both median nerve US and EDS. US measurements of the median nerve cross-sectional area at the distal wrist crease and forearm were used to calculate the median nerve wrist-to-forearm ratio. Read More

World J Clin Cases 2018 Sep;6(9):279-283

Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

Carpal tunnel syndrome (CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons, tendon sheaths, the carpal tunnel floor, transverse carpal ligament, and even the median nerve, causing various symptoms such as pain, numbness, and weakness. Read More

Hand (N Y) 2018 11 12;13(6):NP39-NP45. Epub 2018 Sep 12.

2 NYU Langone Orthopedic Hospital, NYU Langone Health, New York City, USA.

Background: Scaphocapitate syndrome is a rare variety of perilunate instability, described as a trans-scaphoid, trans-capitate fracture, with rotation of the capitate head either 90° or 180°.

Methods: We present a unique case of scaphocapitate syndrome in which the rotated proximal capitate fragment expelled into the carpal canal.

Results: The capitate head was extricated from the carpal tunnel via the volar approach, and was anatomically aligned and fixed through the dorsal approach using two 2. Read More

Swiss Med Wkly 2018 Aug 22;148:w14653. Epub 2018 Aug 22.

Department of Neurosurgery, Kantonsspital Aarau, Switzerland.

Aims Of The Study: Acromegaly due to a growth hormone-secreting pituitary adenoma is a rare disease with high morbidity if not treated adequately. Using data of the Swiss Pituitary Registry (SwissPit), we studied initial presentation and predictors for adverse clinical outcomes in acromegalic patients treated during the last 10 years in our institution.

Methods: We evaluated 21 patients from the SwissPit registry with a final diagnosis of acromegaly confirmed by laboratory results (insulin-like growth factor-1 [IGF-1] and growth hormone suppression tests) and magnetic resonance imaging. Read More

J Bone Joint Surg Am 2018 Aug;100(16):1397-1405

Departments of Radiology (J.-B.N.) and Rehabilitation Medicine (C.H.Y.), Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.

Background: Certain metabolic factors have been proposed as risk factors for a posterosuperior rotator cuff tear. Although metabolic syndrome is of increasing concern in industrialized societies, little information exists regarding its association with posterosuperior rotator cuff tears. The purpose of this study was to determine the risk factors for an atraumatic posterosuperior rotator cuff tear, including metabolic factors and metabolic syndrome. Read More

J Bodyw Mov Ther 2018 07 4;22(3):718-719. Epub 2018 Jul 4.

Eur J Heart Fail 2018 10 2;20(10):1417-1425. Epub 2018 Aug 2.

Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Italy.

Aims: Cardiac amyloidosis remains a great challenge for the cardiologist. One of the three main aetiological forms, transthyretin-related hereditary amyloidosis (ATTRm), can present with several phenotypes, depending mainly on the specific mutation. We aimed to characterize the phenotype of patients with ATTRm due to Ile68Leu mutation, comparing them to patients with wild-type transthyretin amyloidosis (ATTRwt). Read More

Eur J Transl Myol 2018 Apr 24;28(2):7380. Epub 2018 Apr 24.

Mashhad University of Medical Sciences, Mashhad, Iran.

Carpal tunnel syndrome (CTS) is reveled to be the most common peripheral nerve entrapment syndrome, estimating for 90% of all compressive. The diagnosis of CTS is based on the use of clinical criteria and imaging technique tests such as ultrasonography (US) and magnetic resonance imaging (MRI). US is a time-saving method in the diagnosis of CTS, which induces less discomfort to the patient and may be a more cost-effective approach to confirm clinical suspicion of this syndrome . Read More

Eur Radiol 2019 Feb 9;29(2):588-598. Epub 2018 Jul 9.

Department of Radiology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.

Objectives: To assess the diagnostic performance of median nerve (MN) flip-angle measurements, deformation during wrist flexion [transit deformation coefficient (TDC)], during compression [compression deformation coefficient (CDC)] and fascicular freedom to potentially identify fibrotic MN changes in patients with carpal tunnel syndrome (CTS).

Methods: This prospective study was performed with institutional review board approval; all participants provided oral and written informed consent. Wrists in 21 healthy participants and 29 patients with CTS were examined by ultrasound. Read More

Invest Radiol 2018 Dec;53(12):705-713

Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, United Kingdom.

Objectives: The aim of this study was to describe the development of morphologic and diffusion tensor imaging sequences of peripheral nerves at 7 T, using carpal tunnel syndrome (CTS) as a model system of focal nerve injury.

Materials And Methods: Morphologic images were acquired at 7 T using a balanced steady-state free precession sequence. Diffusion tensor imaging was performed using single-shot echo-planar imaging and readout-segmented echo-planar imaging sequences. Read More

Acta Radiol 2019 Mar 6;60(3):347-355. Epub 2018 Jul 6.

1 Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Background: Corticosteroid injections are a popular technique for carpal tunnel syndrome (CTS) treatment and are believed to provide rapid symptom relief.

Purpose: To use magnetic resonance diffusion tensor imaging (MR-DTI) to determine the association between diffusion values of the median nerve (MN) at several anatomic locations and symptom relief in patients with CTS following corticosteroid injection.

Material And Methods: MR-DTI was performed on 15 wrists of 12 patients with CTS before and two weeks after ultrasound-guided corticosteroid injections. Read More

Medicine (Baltimore) 2018 Jun;97(24):e11104

College of Medicine, Prince Sattam bin Abdulaziz University, Al-kharj, Kingdom of Saudi Arabia.

The objective of this study is to determine whether the cross sectional area (CSA) measurement of the median nerve at the wrist differ between carpal tunnel syndrome (CTS) in diabetic patients with and without diabetic polyneuropathy (DPN).This study included 44 patients with type II diabete millitus (DM) with CTS, 32 patients with CTS and DPN, 46 patients with idiopathic CTS, and 42 healthy subjects. Ultrasonographic measurement of the CSA of the median nerve was made at the level of the wrist, together with nerve conduction studies. Read More

J Ultrasound Med 2019 Jan 11;38(1):113-122. Epub 2018 Jun 11.

Department of Physical Therapy and Rehabilitation, Baskent University Hospital, Ankara, Turkey.

Objectives: To evaluate the efficacy of low-level laser therapy on median nerve stiffness by using strain elastography in carpal tunnel syndrome (CTS).

Methods: This study included 37 wrists of 34 patients with mild or moderate CTS between January 2016 and August 2016. The control group comprised 17 patients (18 wrists) with CTS who were treated with wrist splinting for 3 weeks. Read More

J Bodyw Mov Ther 2018 04 31;22(2):348-353. Epub 2017 Oct 31.

Consell Català de l'Esport, Generalitat de Catalunya, Spain.

Objectives: To use ultrasound imaging to show how the needles in dry needling applied in the carpal tunnel can reach the transverse carpal ligament, acting on it in the form of traction-stretching when the fascial winding technique is performed. The potential associated risks are also assessed.

Design: Validation study. Read More

J Hand Surg Asian Pac Vol 2018 Jun;23(2):274-277

† Hand and Microsurgery Unit, Kasturba Medical College, MAHE, Karnataka, India.

We report a case of bilateral carpal tunnel syndrome (CTS) with bilateral bifid median nerve (BMN) without a persistent median artery diagnosed by clinical examination, NCV and Ultrasonography. Bilateral BMN to produce bilateral CTS is extremely rare and is contrary to the popular classifications which state that BMN without persistent median artery or its anomalies will not produce CTS. Ultrasonogram is of additional help to identify such aberrations in the median nerve to prevent iatrogenic injuries during carpal tunnel decompression. Read More

J Biomech 2018 06 12;74:197-201. Epub 2018 Apr 12.

Division of Orthopedic Research, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA. Electronic address:

Higher carpal tunnel pressure is related to the development of carpal tunnel syndrome. Currently, the measurement of carpal tunnel pressure is invasive and therefore, a noninvasive technique is needed. We previously demonstrated that speed of wave propagation through a tendon in the carpal tunnel measured by ultrasound elastography could be used as an indicator of carpal tunnel pressure in a cadaveric model, in which a balloon had to be inserted into the carpal tunnel to adjust the carpal tunnel pressure. Read More

BMJ Case Rep 2018 May 2;2018. Epub 2018 May 2.

Department of Radiology, Duzce University Medical School, Duzce, Turkey.

J Am Coll Radiol 2018 May;15(5S):S39-S55

Specialty Chair, Mayo Clinic, Phoenix, Arizona.

Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, regardless of the suspected diagnosis. When radiographs are normal or equivocal, advanced imaging with MRI (without or without intravenous contrast or following arthrography), CT (usually without contrast), and ultrasound each has a role in establishing a diagnosis. Furthermore, these examinations may contribute to staging disease, treatment planning, and prognostication, even when radiographs are diagnostic of a specific condition. Read More

Neural Regen Res 2018 Apr;13(4):704-708

Department of Orthopedic Surgery, Shanghai Jiao Tong University, Affiliated Sixth People's Hospital, Shanghai, China.

Carpal tunnel syndrome is the most common compressive neuropathy, presenting with sensorimotor dysfunction. In carpal tunnel syndrome patients, irregular afferent signals on functional magnetic resonance imaging are associated with changes in neural plasticity during peripheral nerve injury. However, it is difficult to obtain multi-point neuroimaging data of the brain in the clinic. Read More