Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Neuromuscular Ultrasound Findings in Carpal Tunnel Syndrome with Symptoms Mainly in the Nondominant Hand
Neuromuscular and Clinical Neurophysiology (EMG)
Neuromuscular and Clinical Neurophysiology (EMG) Posters (7:00 AM-5:00 PM)
093
To identify the type and frequency of structural abnormalities in carpal tunnel syndrome (CTS) patients with symptoms mainly in the nondominant hand and to demonstrate the contribution of ultrasound in this subgroup of CTS patients. 

In idiopathic CTS, the dominant hand is almost always the affected hand. CTS that is considerably worse in the nondominant hand should raise suspicion of the presence of structural lesions or anatomical variations at the wrist.

A retrospective chart review was performed on all patients referred to the electromyography laboratory who fulfilled the diagnostic criteria for CTS and who underwent neuromuscular ultrasound.
A total of 415 CTS patients underwent neuromuscular ultrasound study of median nerve from 9/20/2016 to 3/2/2020. Structural abnormalities were found in 143 (34.5%) patients. Abnormalities were more frequent in CTS patients whose symptoms were mainly or limited to nondominant wrist (54 out of 114 patients, 47.4%) than those with symptoms more prominent in dominant wrist or equal bilaterally (89 out of 301 patients, 29.6%) (p < 0.001). The three most common were bifid or trifid median nerve (N=55, 13.3%), tenosynovitis of flexor tendons (N=42, 10.1%), and persistent median artery (N=38, 9.2%). In multivariable analysis, symptoms mainly in nondominant hand and a BMI <30 kg/m2 were the only independent variables significantly associated with structural abnormalities, odd ratios 2.3 (p <0.001) and 1.9 (p=0.006), respectively.

Neuromuscular ultrasound, in addition to electrodiagnostic studies, should always be considered in all CTS patients with symptoms mainly in nondominant wrist as a significant number have abnormal structural abnormalities that may be causative or change the therapeutic approach.
Authors/Disclosures
Pitcha Chompoopong, MD (University of Minnesota)
PRESENTER 		Dr. Chompoopong has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astrazeneca. Dr. Chompoopong has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alnylam.
David C. Preston, MD, FÂ鶹´«Ã½Ó³»­ (University Hospitals - Cleveland Medical Center) Dr. Preston has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for FBI, US Attorney, Insurance Fraud Investigative Units. Dr. Preston has received publishing royalties from a publication relating to health care.