Ultrasonographic assessment of longitudinal median nerve and hand flexor tendon dynamics in carpal tunnel syndrome

Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The NetherlandsAccepted 14 November 2011ABSTRACT: Introduction: Changes in subsynovial connectivetissue (SSCT) in carpal tunnel syndrome (CTS) patients mayresult in altered dynamics; consequently, quantification of thesedynamics might support objective diagnosis of CTS. Methods:We measured and compared longitudinal excursion of the flexordigitorum superficialis and profundus tendons, the mediannerve, and the SSCT between the most and least affectedhands of 51 CTS patients during extension-to-fist motion.Results: Median nerve and flexor digitorum superficialis tendonexcursions in the most affected hands were smaller than in theleast affected hands of the same patients, whereas the excur-sions of the flexor digitorum profundus were larger. Basedon these excursions, logistic regression models classifiedbetween 67% and 86% of the hands correctly as having CTS.Conclusions: The altered hand dynamics in CTS patients mayhave implications for the pathophysiology and clinical evaluationof CTS, and ultrasound-based classification models may furthersupport the diagnosis of CTS.