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

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
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Publication History

Publication Date:
11 November 2010 (online)

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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

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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