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Efficacy of high frequency ultrasound in postoperative evaluation of carpal tunnel syndrome treatment.

Kapuścińska K, Urbanik A - J Ultrason (2016)

Bottom Line: The main treatment is operation.Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6-18 MHz, using 18 MHz band) of MyLab 70/Esaote.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Private Specialist Practice, Kraków, Poland; Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

ABSTRACT

Unlabelled: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and a frequent cause of sick leave because of work-related hand overload. The main treatment is operation.

Aim: The aim of the study is to assess the usefulness of high frequency ultrasound in the postoperative evaluation of CTS treatment efficacy.

Material and methods: Sixty-two patients (50 women and 12 men aged 28-70, mean age 55.2) underwent surgical treatment of CTS. Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6-18 MHz, using 18 MHz band) of MyLab 70/Esaote. On the basis of the collected data, the author has performed multiple analyses to confirm the usefulness of ultrasound imaging for postoperative evaluation of CTS treatment efficacy.

Results: Among all 62 patients, 3 months after surgical median nerve decompression: in 40 patients, CTS symptoms subsided completely, and sonographic evaluation did not show median nerve entrapment signs; in 9 patients, CTS symptoms persisted or exacerbated, and ultrasound proved nerve compression revealing preserved flexor retinaculum fibers; in 13 patients, scar tissue symptoms occurred, and in 5 of them CTS did not subside completely (although ultrasound showed no signs of compression).

Conclusions: Ultrasound imaging with the use of a high frequency transducer is a valuable diagnostic tool for postoperative assessment of CTS treatment efficacy.

No MeSH data available.


Related in: MedlinePlus

Longitudinal view of the median nerve 3 months after surgical median nerve decompression: red asterisks mark preserved fibers of the flexor retinaculum, yellow asterisks indicate scar tissue between divided parts of the flexor retinaculum and blue arrows point to the “notch” and “inverted notch” sign
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Figure 0002: Longitudinal view of the median nerve 3 months after surgical median nerve decompression: red asterisks mark preserved fibers of the flexor retinaculum, yellow asterisks indicate scar tissue between divided parts of the flexor retinaculum and blue arrows point to the “notch” and “inverted notch” sign

Mentions: Early examinations enable incompletely divided fibers to be easily differentiated from scars since they present different echogenicity. Scars are initially hypoechoic and amorphous whilst flexor retinaculum fibers are hyperechoic and present a typical course in the ligament line (Fig. 1 and 2). The differentiation becomes more difficult, and sometimes even impossible, as fibrous remodeling of scar tissue progresses. No improvement (symptoms do not subside) after surgery can therefore be an indication for conducting a US examination in the first 1–3 months post-treatment.


Efficacy of high frequency ultrasound in postoperative evaluation of carpal tunnel syndrome treatment.

Kapuścińska K, Urbanik A - J Ultrason (2016)

Longitudinal view of the median nerve 3 months after surgical median nerve decompression: red asterisks mark preserved fibers of the flexor retinaculum, yellow asterisks indicate scar tissue between divided parts of the flexor retinaculum and blue arrows point to the “notch” and “inverted notch” sign
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834367&req=5

Figure 0002: Longitudinal view of the median nerve 3 months after surgical median nerve decompression: red asterisks mark preserved fibers of the flexor retinaculum, yellow asterisks indicate scar tissue between divided parts of the flexor retinaculum and blue arrows point to the “notch” and “inverted notch” sign
Mentions: Early examinations enable incompletely divided fibers to be easily differentiated from scars since they present different echogenicity. Scars are initially hypoechoic and amorphous whilst flexor retinaculum fibers are hyperechoic and present a typical course in the ligament line (Fig. 1 and 2). The differentiation becomes more difficult, and sometimes even impossible, as fibrous remodeling of scar tissue progresses. No improvement (symptoms do not subside) after surgery can therefore be an indication for conducting a US examination in the first 1–3 months post-treatment.

Bottom Line: The main treatment is operation.Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6-18 MHz, using 18 MHz band) of MyLab 70/Esaote.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Private Specialist Practice, Kraków, Poland; Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

ABSTRACT

Unlabelled: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and a frequent cause of sick leave because of work-related hand overload. The main treatment is operation.

Aim: The aim of the study is to assess the usefulness of high frequency ultrasound in the postoperative evaluation of CTS treatment efficacy.

Material and methods: Sixty-two patients (50 women and 12 men aged 28-70, mean age 55.2) underwent surgical treatment of CTS. Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6-18 MHz, using 18 MHz band) of MyLab 70/Esaote. On the basis of the collected data, the author has performed multiple analyses to confirm the usefulness of ultrasound imaging for postoperative evaluation of CTS treatment efficacy.

Results: Among all 62 patients, 3 months after surgical median nerve decompression: in 40 patients, CTS symptoms subsided completely, and sonographic evaluation did not show median nerve entrapment signs; in 9 patients, CTS symptoms persisted or exacerbated, and ultrasound proved nerve compression revealing preserved flexor retinaculum fibers; in 13 patients, scar tissue symptoms occurred, and in 5 of them CTS did not subside completely (although ultrasound showed no signs of compression).

Conclusions: Ultrasound imaging with the use of a high frequency transducer is a valuable diagnostic tool for postoperative assessment of CTS treatment efficacy.

No MeSH data available.


Related in: MedlinePlus