Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparison of Conduction Velocity and Cross-Sectional Area of Median Nerve in Healthy Individuals with and Without Cuboid Wrist

Document Type : Original Article(s)

Authors
Saeid Khosrawi 1
Shila Haghighat 2
Parvin Fotros 3
1 Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Specialist in Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v41.i709.0118
Abstract
Background: The cuboid or square shaped wrist has been suggested in the previous studies as a predisposing factor for CTS. The aim of this study was to compare the conduction velocity and cross-sectional area of the median nerve in the wrist of healthy individuals with and without a cuboid wrist in ultrasonographic and electrodiagnostic studies.
Methods: In a analytic cross-sectional study, the volunteers at the beginning of the study, antero-posterior and medio-lateral diameters of their wrists were measured by calipers and those with a wrist-ratio greater than or equal to0.7were considered as a case group and individuals with lesser were considered as a control group. Then, the cross-sectional area of the median nerve at the entrance of the carpal tunnel was assessed by ultrasound and the conduction velocity of the nerve was assessed by electrodiagnostic tests in both groups.
Findings: In this study, 80 healthy hands were evaluated in two groups with and without cuboid wrist. The mean nerve conduction velocity in the median nerve was 47.15 m/s in individuals with a cuboid wrist and 51.93m/s in healthy individuals.The mean cross-sectional area of the median nerve in individuals with a cuboid wrist and in the control group was 10.6mm and 8.2mm, respectively.
Conclusion: The present study showed that the mean cross-sectional area of the median nerve in healthy individuals with a cuboid wrist is higher and the use of ultrasound in the diagnosis of CTS in these individuals may be associated with a false positive result. Therefore, it is necessary to consider the wrist-ratio and further evaluations in these people.
Keywords
Median nerve
Carpal tunnel syndrome
Ultrasound
Electrodiagnosis
Subjects
  1. Hunderfund ANL, Boon AJ, Mandrekar JN, Sorenson EJ. Sonography in carpal tunnel syndrome. Muscle Nerve 2011; 44(4): 485-91.
  2. Wright AR, Atkinson RE. Carpal tunnel syndrome: An update for the primary care physician. Hawaii J Health Soc Welf 2019; 78(11 Suppl 2): 6-10.
  3. Mondelli M, Rossi S, Monti E, Aprile I, Caliandro P, Pazzaglia C, et al. Prospective study of positive factors for improvement of carpal tunnel syndrome in pregnant women. Muscle Nerve 2007; 36(6): 778-83.
  4. Takahashi T, Kato A, Ikegaya N. Ultrasound changes of the carpal tunnel in patients receiving long-term hemodialysis: a cross-sectional and longitudinal study. Clin Nephrol 2002; 57(3): 230-6.
  5. Ibrahim I, Khan WS, Goddard N, Smitham P. Carpal tunnel syndrome: A review of the recent literature. Open Orthop J 2012; 6: 69-76.
  6. Ablove RH, Ablove TS. Prevalence of carpal tunnel syndrome in pregnant women. WMJ 2009; 108(4): 194-6.
  7. Wright C, Smith B, Wright S, Weiner M, Wright K, Rubin D. Who develops carpal tunnel syndrome during pregnancy: An analysis of obesity, gestational weight gain, and parity. Obstet Med 2014; 7(2): 90-4.
  8. Gharehdaghi M, Rahimi H, Rezai H, Hasanabadi H, Kashefi H. Assessment of sonographic measurement of carpal tunnel diameters with clinical and electrodiagnostic findings in carpal tunnel syndrome [in Persian]. Med J Mashhad Univ Med Sci 2012; 55(2): 69-75.
  9. Mondelli M, Filippou G, Gallo A, Frediani B. Diagnostic utility of ultrasonography versus nerve conduction studies in mild carpal tunnel syndrome. Arthritis Rheum 2008; 59(3): 357-66.
  10. Cartwright MS, Hobson-Webb LD, Boon AJ, Alter KE, Hunt CH, Flores VH, et al. Evidence-based guideline: neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome. Muscle Nerve 2012; 46(2): 287-93.
  11. Deniz FE, Öksüz E, Sarikaya Ba, Kurt S, Erkorkmaz Ü, Ulusoy H, et al. Comparison of the diagnostic utility of electromyography, ultrasonography, computed tomography, and magnetic resonance imaging in idiopathic carpal tunnel syndrome determined by clinical findings. Neurosurgery 2012; 70(3): 610-6.
  12. Nakamichi KI, Tachibana S. Ultrasonographic measurement of median nerve cross-sectional area in idiopathic carpal tunnel syndrome: diagnostic accuracy. Muscle Nerve 2002; 26(6): 798-803.
  13. De Kleermaeker FGCM, Meulstee J, Verhagen WIM. The controversy of the normal values of ultrasonography in carpal tunnel syndrome: diagnostic accuracy of wrist-dependent CSA
    Neurol Sci 2019; 40(5): 1041-7.
  14. Shiri R. A square-shaped wrist as a predictor of carpal tunnel syndrome: A meta-analysis. Muscle Nerve 2015; 52(5): 709-13.
  15. Nakamichi KI, Tachibana S. Enlarged median nerve in idiopathic carpal tunnel syndrome. Muscle Nerve 2000; 23(11): 1713-8.
  16. Rahbar S, Elmi H, Torabian S, Rashedi V. Relationship between wrist cross-section and carpal tunnel syndrome [in Persian]. Iran J War Public Health 2012; 4(1): 1-5.
  17. Rayegani M, Mokhtari Rad M, Bahrami M, Eliaspour D, valaie N. Frequency of carpal tunnel syndrome and its related risk factors in patients upper extremity pain [in Persian]. Pajoohande 2009; 14(4): 219-23.
  18. Moghtaderi A, Izadi S, Sharafadinzadeh N. An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome. Acta Neurol Scand 2005; 112(6): 375-9.
  19. Rezazadeh A, Bakhtiary AH, Samaei A, Moghimi J, Ghorbani R. Diagnostic value of ultrasonography using median nerve-tunnel index in patients with carpal tunnel syndrome [in Persian]. Koomesh 2014; 15(4): 530-40.
  20. Dalili AR, Mardani-Kivi M, Alizadeh A, Hatamian HR, Hoseininejad M, Peyrazm H, et al. Comparison between sonography and electrodiagnostic testing in the diagnosis of carpal tunnel syndrome [in Persian]. J Anesth Pain 2011; 2(5): 43-51.
Journal of Isfahan Medical School
Volume 41, Issue 709
1st Week, May
May and June 2023
Pages 118-123

  • Receive Date 07 February 2023
  • Revise Date 05 April 2023
  • Accept Date 09 April 2023