Entrapment Neuropathies II: Carpal Tunnel Syndrome

Andrea S Klauser; Ralph Faschingbauer; Thomas Bauer; Marius C Wick; Markus Gabl; Rohit Arora; Anne Cotten; Carlo Martinoli; Werner R Jaschke

doi:10.1055/s-0030-1268069

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2010; 14(5): 487-500
DOI: 10.1055/s-0030-1268069

Entrapment Neuropathies II: Carpal Tunnel Syndrome

Andrea S. Klauser¹ , Ralph Faschingbauer¹ , Thomas Bauer³ , Marius C. Wick¹ , Markus Gabl² , Rohit Arora² , Anne Cotten⁴ , Carlo Martinoli⁵ , Werner R. Jaschke¹

¹Department of Diagnostic Radiology, Medical University Innsbruck, Innsbruck, Austria
²Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck, Innsbruck, Austria
³Department of Plastic Surgery, Medical University Innsbruck, Innsbruck, Austria
⁴Service de Radiologie et Imagerie Musculosquelettique, centre de consultation et d'imagerie de l'Appareil Locomoteur, Lille, France
⁵Department of Radiology–DISC, University of Genoa, Genoa, Italy

Abstract

ABSTRACT

Diagnostic tests in patients complaining of carpal tunnel syndrome (CTS) are based on physical examination, electrodiagnostic tests (EDTs), and diagnostic imaging. Timely diagnosis helps prevent permanent nerve damage and its sequelae in terms of functional impairment. Imaging provides additional information to that obtained from clinical tests and EDTs. By allowing direct visualization of the compressed median nerve (MN), ultrasound (US) and magnetic resonance imaging can depict the causes for secondary CTS and describe anatomical variants, such as a bifid MN or a persistent median artery of the forearm, as well as space-occupying lesions including tenosynovitis and ganglion cysts. In addition, diagnostic imaging is of value for postoperative patients presenting with persistent symptoms. Finally, US is able to add information for EDT-negative symptomatic patients. Over time, US has increased in its sensitivity and specificity so it can be used as the initial test in patients presenting with clinical symptoms of CTS because it is now equivalent to EDT. The use of US as a screening test may reduce the number of EDT examinations in patients with suspected CTS, providing additional valuable anatomical information.

KEYWORDS

Carpal tunnel - ultrasound - sonography - magnetic resonance imaging - electroneurography - ultrasound guidance

Full Text

References

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Andrea S KlauserM.D.

Department of Diagnostic Radiology, Anichstrasse 35

Medical University Innsbruck, 6020 Innsbruck, Austria

Email: andrea.klauser@i-med.ac.at