KARPAL TÜNEL SENDROMU TANISINDA ULTROSONOGRAFİNİN TANI DEĞERİ Diagnostic Value of Ultrasonography in Carpal Tunnel Syndrome Diagnosis

OZET Median sinir ele osteofibroz bir kanal olan karpal tuneli gecerek girer. Karpal Tunel Sendromu (KTS) median sinirin karpal tunel icerisinde sikisma (tuzak-entrapment) noropatisi olup en sik gorulen tuzak noropatidir. KTS’ye norosirurji, ortopedi ve fizik tedavi pratiklerinde sikca rastlanmaktadir. Sik gorulmesi nedeniyle uzerine yogun olarak calisilmasi, klinik, elektrofizyolojik ve tedavi acisindan iyi tanimlanmasi gerekli olmustur. Median sinirin karpal kanal icerisinde kompresyonu sonucu elde median sinire uyan alanlarda ozellikle geceleri ve tekrarlayan el bilegi aktiviteleri sonrasinda belirginlesen parestezi ve agri yakinmalari on plandadir. Bununla birlikte gec donemde tenar kaslarda gucsuzluk ve atrofi gorulebilir. Sonucta kisinin gunluk akvitelerini engelleyebilir. KTS tanisi hastanin hikayesi, klinik muayene ve EMG ile konur. Radyolojik goruntuleme yontemleri (Direkt grafi, USG, BT ve MR) KTS’li bazi hastalarda kuskulu patolojilerin aciklanmasinda ve karpal tunel patogenezinin anlasilmasinda yardimci olmaktadir. Bu calismada, klinik olarak ve EMG ile KTS tanisi almis hastalarin el bilekleri yuksek rezolusyonluyuzeyel ultrasonografi ile incelenerek, elde edilen bulgular klinik tani ile karsilastirildi. Sonucta, inceleme zamam kisa, maliyeti dusuk, ulasilmasi kolay ve noninvaziv bir yontem olan ultrasonografinin KTS’deki tani degeri arastirildi. Anahtar Sozcu¨kler: Karpal tunel sendromu; EMG; Ultrasonografi ABSTRACT Objectives: Median Nerve comes into hand by going through Carpal Tunnel which is an osteofibrous canal. Carpal Tunnel Syndrome (CTS) is the neuropathy of in carceration of median nerve in carpal tunnel, which is most commonly seen trap neuropathy. In this study, the wrists of patients who have been diagnosed as CTS by EMG and clinical way have been analysed by high resolusion superficial ultrasonography and the findings have been compared with clinical diagnosis. Material and Methods: 24 cases, having been diagnosed as CTS with EMG and clinically, 23 females and 1 male were evaluated by ultrosonography. In control group, 27 wrists selected randomly, were researched which don’t have any physical examination findings and any suffering related with CTS. Findings: In patients group the average crosssectional area of median nerve has been found as 0,1211 cm2 and faltting rate average has been found as 3,05. Moreover, in control group, the average cosssectional area of median nerve has been found as 0,0746 cm2 and flatting rate average has been found as 2,44. When these data have been compared statistically the values belong to crosssectional area of median nerve, transverse diameter and flatting rate don’t have any meaningful differences statistically between these two groups. Conclusion: Diagnosis value of ultrasoundography which has characteristics such as; time savinging in examining, low cost, easy to reach, and a noninvaziv method in CTS has been searched. Keywords: Carpal Tunnel Sendrom; EMG; Ultrasonography