Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome
ABSTRACT Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the c...
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| Veröffentlicht in: | Journal of orthopaedic research 2015-09, Vol.33 (9), p.1332-1340 |
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| container_title | Journal of orthopaedic research |
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| creator | Filius, Anika Scheltens, Marjan Bosch, Hans G. van Doorn, Pieter A. Stam, Henk J. Hovius, Steven E. R. Amadio, Peter C. Selles, Ruud W. |
| description | ABSTRACT
Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross‐sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70–71% and specificity of 80–84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1332–1340, 2015. |
| doi_str_mv | 10.1002/jor.22909 |
| format | Article |
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Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross‐sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70–71% and specificity of 80–84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1332–1340, 2015.</description><identifier>ISSN: 0736-0266</identifier><identifier>EISSN: 1554-527X</identifier><identifier>DOI: 10.1002/jor.22909</identifier><identifier>PMID: 25865180</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Algorithms ; Biomechanical Phenomena ; biomechanics ; Carpal tunnel syndrome ; Carpal Tunnel Syndrome - diagnostic imaging ; Case-Control Studies ; displacement ; Female ; Humans ; Male ; Median Nerve - diagnostic imaging ; Middle Aged ; Prospective Studies ; Regression Analysis ; Sensitivity and Specificity ; tendon ; Tendons - diagnostic imaging ; Tendons - pathology ; Ultrasonography - methods ; ultrasound ; Wrist - diagnostic imaging ; Wrist Joint - diagnostic imaging</subject><ispartof>Journal of orthopaedic research, 2015-09, Vol.33 (9), p.1332-1340</ispartof><rights>2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5239-300229966e9fa27dd0046861615cf2a3ba66bf369de501430148795034f980b73</citedby><cites>FETCH-LOGICAL-c5239-300229966e9fa27dd0046861615cf2a3ba66bf369de501430148795034f980b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjor.22909$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjor.22909$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25865180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Filius, Anika</creatorcontrib><creatorcontrib>Scheltens, Marjan</creatorcontrib><creatorcontrib>Bosch, Hans G.</creatorcontrib><creatorcontrib>van Doorn, Pieter A.</creatorcontrib><creatorcontrib>Stam, Henk J.</creatorcontrib><creatorcontrib>Hovius, Steven E. R.</creatorcontrib><creatorcontrib>Amadio, Peter C.</creatorcontrib><creatorcontrib>Selles, Ruud W.</creatorcontrib><title>Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome</title><title>Journal of orthopaedic research</title><addtitle>J. Orthop. Res</addtitle><description>ABSTRACT
Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross‐sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70–71% and specificity of 80–84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1332–1340, 2015.</description><subject>Adult</subject><subject>Algorithms</subject><subject>Biomechanical Phenomena</subject><subject>biomechanics</subject><subject>Carpal tunnel syndrome</subject><subject>Carpal Tunnel Syndrome - diagnostic imaging</subject><subject>Case-Control Studies</subject><subject>displacement</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Median Nerve - diagnostic imaging</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><subject>Sensitivity and Specificity</subject><subject>tendon</subject><subject>Tendons - diagnostic imaging</subject><subject>Tendons - pathology</subject><subject>Ultrasonography - methods</subject><subject>ultrasound</subject><subject>Wrist - diagnostic imaging</subject><subject>Wrist Joint - diagnostic imaging</subject><issn>0736-0266</issn><issn>1554-527X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0EotPCghdAXsIirX9iJ2aBxAz9oSqthECwszzJzYxLYgc7aZmH4J3xkM4IFiwsy_Z3z7nXB6EXlBxTQtjJrQ_HjCmiHqEZFSLPBCu-PUYzUnCZESblATqM8ZYQUlBWPkUHTJRS0JLM0K-PYzvY2nbgovXOtDidg4l-dDW2nVlZt8K-wcMa8H2wcXiDF2vjVhC3t3FtesAmobWNfWsqSDrDju-gtsZhB-FuggZwtXcRW4crE_pkNozOQYvjxtXBd_AMPWlMG-H5w36Evpydfl5cZFc35x8W766ySjCuMp6GZkpJCaoxrKhrQnJZSiqpqBpm-NJIuWy4VDUIQnOeVlkoQXjeqJIsC36E3k66_bhMXVap6WBa3Yc0cdhob6z-98XZtV75O50LlhRoEnj1IBD8jxHioDsbK2hb48CPUdMifbuglG29Xk9oFXyMAZq9DSV6G59O8ek_8SX25d997cldXgk4mYB728Lm_0r68ubTTjKbKlJ28HNfYcJ3LQteCP31-lzP5xfz99fzS33GfwPQFbYf</recordid><startdate>201509</startdate><enddate>201509</enddate><creator>Filius, Anika</creator><creator>Scheltens, Marjan</creator><creator>Bosch, Hans G.</creator><creator>van Doorn, Pieter A.</creator><creator>Stam, Henk J.</creator><creator>Hovius, Steven E. R.</creator><creator>Amadio, Peter C.</creator><creator>Selles, Ruud W.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201509</creationdate><title>Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome</title><author>Filius, Anika ; Scheltens, Marjan ; Bosch, Hans G. ; van Doorn, Pieter A. ; Stam, Henk J. ; Hovius, Steven E. R. ; Amadio, Peter C. ; Selles, Ruud W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5239-300229966e9fa27dd0046861615cf2a3ba66bf369de501430148795034f980b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Algorithms</topic><topic>Biomechanical Phenomena</topic><topic>biomechanics</topic><topic>Carpal tunnel syndrome</topic><topic>Carpal Tunnel Syndrome - diagnostic imaging</topic><topic>Case-Control Studies</topic><topic>displacement</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Median Nerve - diagnostic imaging</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Regression Analysis</topic><topic>Sensitivity and Specificity</topic><topic>tendon</topic><topic>Tendons - diagnostic imaging</topic><topic>Tendons - pathology</topic><topic>Ultrasonography - methods</topic><topic>ultrasound</topic><topic>Wrist - diagnostic imaging</topic><topic>Wrist Joint - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Filius, Anika</creatorcontrib><creatorcontrib>Scheltens, Marjan</creatorcontrib><creatorcontrib>Bosch, Hans G.</creatorcontrib><creatorcontrib>van Doorn, Pieter A.</creatorcontrib><creatorcontrib>Stam, Henk J.</creatorcontrib><creatorcontrib>Hovius, Steven E. R.</creatorcontrib><creatorcontrib>Amadio, Peter C.</creatorcontrib><creatorcontrib>Selles, Ruud W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of orthopaedic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Filius, Anika</au><au>Scheltens, Marjan</au><au>Bosch, Hans G.</au><au>van Doorn, Pieter A.</au><au>Stam, Henk J.</au><au>Hovius, Steven E. R.</au><au>Amadio, Peter C.</au><au>Selles, Ruud W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome</atitle><jtitle>Journal of orthopaedic research</jtitle><addtitle>J. Orthop. Res</addtitle><date>2015-09</date><risdate>2015</risdate><volume>33</volume><issue>9</issue><spage>1332</spage><epage>1340</epage><pages>1332-1340</pages><issn>0736-0266</issn><eissn>1554-527X</eissn><abstract>ABSTRACT
Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross‐sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70–71% and specificity of 80–84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1332–1340, 2015.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25865180</pmid><doi>10.1002/jor.22909</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Algorithms Biomechanical Phenomena biomechanics Carpal tunnel syndrome Carpal Tunnel Syndrome - diagnostic imaging Case-Control Studies displacement Female Humans Male Median Nerve - diagnostic imaging Middle Aged Prospective Studies Regression Analysis Sensitivity and Specificity tendon Tendons - diagnostic imaging Tendons - pathology Ultrasonography - methods ultrasound Wrist - diagnostic imaging Wrist Joint - diagnostic imaging |
| title | Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome |
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