Separation of carpal tunnel syndrome associated with axonal degeneration using via ratio of carpal tunnel outlet readings by ultrasound

Joint Event on 3^rd International conference on Neuroscience, Neuroradiology and Imaging & World Congress on Clinical, Pediatric and Neuro Ophthalmology

October 03-04, 2018 Osaka, Japan

Deng Xue, Chau Lai-Heung, Chiu Suk-Yee, Leung Kwok Pui, Li Sheung-Wai and Ip Wing-Yuk

The University of Hong Kong, Hong Kong

Posters & Accepted Abstracts: J Pediatr Neurol Med

Abstract :

Nerve Conduction Studies (NCS) and Ultra Sonography (US) have been cross-validated for diagnostic confirmation and gradation of severity of the Carpal Tunnel Syndrome (CTS), a median nerve compression injury at the wrist. However, NCS cannot differentiate the CTS with demyelination alone from the disease with secondary axonal degeneration. Yet it is unknown if Ultrasound (US) can compensate this deficit. This study aimed at exploring US to differentiate CTS with demyelination only from that in association with axonal degeneration. We studied 39 demyelinated CTS hands and 154 demyelinated CTS hands with axonal degeneration in sensory median nerves by comparing Cross-Sectional Area (CSA-W) and Perimeter (PW) of median nerve at wrist, ratio of CSA (R-CSA) and P(R-P) of wrist over mid-forearm measured by US. Results revealed significant differences in R-CSA (p=0.013) and R-P (p=0.05) while descriptive differences in CSA-W and P-W. ROC curves indicated significant accuracy of R-CSA (Area=0.62, p=0.015) and R-P (Area=0.615, p=0.02). The cut-off value of R-CSA to indicate CTS associated with axonal degeneration is 1.8 with sensitivity of 71% and specificity of 45% while 1.5 for R-P with sensitivity of 70% and specificity of 43%. Our findings were consistent with previous relevant studies and the result would be more robust should more cases be enrolled. We conclude that US may be potentially used to differentiate demyelinated CTS from that with axonal degeneration in clinical practice. This finding can improve diagnostic efficiency in clinical practice and help patients to choose appropriate treatment.

Biography :

E-mail: dannytang023@gmail.com