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An evaluation of radial and ulnar artery flow characteristics in diabetic patients with carpal tunnel syndrome and the diagnostic value of ultrasonography in these patients

Year 2014, Volume: 5 Issue: 2, 179 - 185, 01.06.2014
https://doi.org/10.5799/ahinjs.01.2014.02.0386

Abstract

Objectives: This study aimed to research the value of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS) in patients with diabetes mellitus (DM) and to examine the flow characteristics of the radial and ulnar arteries in diabetic patients with CTS. Methods: A total of 23 diabetic hands diagnosed with CTS from electrophysiological evaluation (DM-CTS), 47 asymptomatic diabetic hands (DM) and 50 healthy hands (C) as the control group were evaluated with high resolution ultrasonography. The median nerve was measured in the cross-sectional area (CSA), flattening ratio (FR) and at the level of the carpal tunnel inlet [proximal (p)] and the wrist crease [distal (d)]. The radial and ulnar arteries were evaluated with both hands in a neutral position. Results: In the DM-CTS group, the CSA-p and CSA-d values were statistically signficantly greater compared to the DM and C groups (p

References

  • Perkins BA, Olaleye D, Bril V. Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care 2002;25:565-569.
  • Jablecki CK, Andary MT, So YT, et al. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve 1993;16:1392-1414.
  • Tsai NW, Lee LH, Huang CR, et al. The diagnostic value of ultrasonography in carpal tunnel syndrome: a comparison between diabetic and non-diabetic pa- tients. BMC Neurol 2013;13:65-72.
  • Chen SF, Huang CR, Tsai NW, et al. Ultrasonographic assessment of carpal tunnel syndrome of mild and moderate severity in diabetic patients by using an 8-point measurement of median nerve cross-sectional areas. BMC Med Imaging 2012;12:15-24.
  • Visser LH, Smidt MH, Lee ML. High-resolution so- nography versus EMG in the diagnosis of carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 2008;79:63-67.
  • El Miedany YM, Aty SA, Ashour S. Ultrasonography versus nerve conduction study in patients with car- pal tunnel syndrome: substantive or complementary tests? Rheumatology (Oxford) 2004;43:887-895.
  • Becker J, Nora DB, Gomes I, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk fac- tors for carpal tunnel syndrome. Clin Neurophysiol 2002;113:1429-1434.
  • Uzkeser H, Karatay S, Alkan Melikoğlu M. Levels of endocrine hormones and lipids in male patients with carpal tunnel syndrome. Dicle Medical Journal 2011;38:427-431.
  • Ozcan HN, Kara M, Ozcan F, et al. Dynamic Doppler evaluation of the radial and ulnar arteries in patients with carpal tunnel syndrome. AJR Am J Roentgenol 2011;197:817-820.
  • Ghasemi-Esfe AR, Morteza A, Khalilzadeh O, Ma- zloumi M, Ghasemi-Esfe M, Rahmani M. Color Dop- pler ultrasound for evaluation of vasomotor activity in patients with carpal tunnel syndrome. Skeletal Radiol 2012;41:281-286.
  • American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 2006;35:64-71.
  • You H, Simmons Z, Freivalds A, Kothari MJ, Naidu SH. Relationships between clinical symptom severity scales and nerve conduction measures in carpal tun- nel syndrome. Muscle Nerve 1999;22:497-501.
  • Keith MW, Masear V, Chung K, et al. Diagnosis of carpal tunnel syndrome. J Am Acad Orthop Surg 2009;17:389-396.
  • Jackson DA, Clifford JC. Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys Med Rehabil 1989;70:199-204.
  • Uncini A, Lange DJ, Solomon M, Soliven B, Meer J, Lovelace RE. Ring finger testing in carpal tunnel syndrome: a comparative study of diagnostic utility. Muscle Nerve 1989;12:735-741.
  • Chen SF, Lu CH, Huang CR, et al. Ultrasonograph- ic median nerve cross-section areas measured by 8-point “inching test” for idiopathic carpal tunnel syn- drome: a correlation of nerve conduction study sever- ity and duration of clinical symptoms. BMC Med Imag- ing 2011;11:22-30.
  • Mackinnon SE. Pathophysiology of nerve compres- sion. Hand Clin 2002;18:231-241.
  • Yagihashi S. Recent advances in clinical practice and in basic research on diabetic neuropathy]. Brain Nerve 2011;63:571-582.
  • Thomsen NO, Mojaddidi M, Malik RA, Dahlin LB. Reduced myelinated nerve fibre and endoneurial capillary densities in the forearm of diabetic and non- diabetic patients with carpal tunnel syndrome. Acta Neuropathol 2009;118:785-791.
  • Hunderfund AN, Boon AJ, Mandrekar JN, Sorenson EJ Sonography in carpal tunnel syndrome. Muscle Nerve 2011;44:485-491.
  • Seror P. Sonography and electrodiagnosis in carpal tunnel syndrome diagnosis, an analysis of the litera- ture. Eur J Radiol 2008;67:146-152.
  • Jordan SE, Greider JL, Jr. Autonomic activity in the carpal tunnel syndrome. Orthop Rev 1987;16:165- 169.
  • Sugimoto H, Miyaji N, Ohsawa T (1994) Carpal tunnel syndrome: evaluation of median nerve circulation with dynamic contrast-enhanced MR imaging. Radiology 1994;190:459-466.
  • Şen TA, Bükülmez A, Köken R, et al. Tip 1 Diabetes Mellituslu Çocukların Retinal Doppler Ultrasonografi Bulguları ve Homosistein Düzeyleri. Güncel Pediatri 2008;6:19-25.

Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri

Year 2014, Volume: 5 Issue: 2, 179 - 185, 01.06.2014
https://doi.org/10.5799/ahinjs.01.2014.02.0386

Abstract

Amaç: Diabetes mellituslu (DM) hastalarda karpal tünel sendromu (KTS) teşhisinde ultrasonografinin değerini ve diabetik KTS\'li hastalarda radial ve ulnar arterlerin akım karakteristiklerini araştırmak amaçlanmıştır. Yöntemler: Elektrofizyolojik değerlendirme ile KTS tesbit edilen 23 el (DM-KTS), asemptomatik 47 el (DM) ve 50 sağlıklı el kontrol grubu (C), yüksek rezolüsyonlu ultrasonografiyle değerlendirildi. Median sinir kesit alanı (CSA) ve düzleşme oranı (FR), karpal tünel girişi [proksimal (p)] ve bilek kıvrımı [distal (d)] düzeylerden ölçüldü. Her iki el nötral pozisyonda iken radial ve ulnar arterler değerlendirildi. Bulgular: DM-KTS grubunda, CSA-p ve CSA-d değerleri DM ve C gruplarına göre anlamlı olarak daha büyüktü (p

References

  • Perkins BA, Olaleye D, Bril V. Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care 2002;25:565-569.
  • Jablecki CK, Andary MT, So YT, et al. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve 1993;16:1392-1414.
  • Tsai NW, Lee LH, Huang CR, et al. The diagnostic value of ultrasonography in carpal tunnel syndrome: a comparison between diabetic and non-diabetic pa- tients. BMC Neurol 2013;13:65-72.
  • Chen SF, Huang CR, Tsai NW, et al. Ultrasonographic assessment of carpal tunnel syndrome of mild and moderate severity in diabetic patients by using an 8-point measurement of median nerve cross-sectional areas. BMC Med Imaging 2012;12:15-24.
  • Visser LH, Smidt MH, Lee ML. High-resolution so- nography versus EMG in the diagnosis of carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 2008;79:63-67.
  • El Miedany YM, Aty SA, Ashour S. Ultrasonography versus nerve conduction study in patients with car- pal tunnel syndrome: substantive or complementary tests? Rheumatology (Oxford) 2004;43:887-895.
  • Becker J, Nora DB, Gomes I, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk fac- tors for carpal tunnel syndrome. Clin Neurophysiol 2002;113:1429-1434.
  • Uzkeser H, Karatay S, Alkan Melikoğlu M. Levels of endocrine hormones and lipids in male patients with carpal tunnel syndrome. Dicle Medical Journal 2011;38:427-431.
  • Ozcan HN, Kara M, Ozcan F, et al. Dynamic Doppler evaluation of the radial and ulnar arteries in patients with carpal tunnel syndrome. AJR Am J Roentgenol 2011;197:817-820.
  • Ghasemi-Esfe AR, Morteza A, Khalilzadeh O, Ma- zloumi M, Ghasemi-Esfe M, Rahmani M. Color Dop- pler ultrasound for evaluation of vasomotor activity in patients with carpal tunnel syndrome. Skeletal Radiol 2012;41:281-286.
  • American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 2006;35:64-71.
  • You H, Simmons Z, Freivalds A, Kothari MJ, Naidu SH. Relationships between clinical symptom severity scales and nerve conduction measures in carpal tun- nel syndrome. Muscle Nerve 1999;22:497-501.
  • Keith MW, Masear V, Chung K, et al. Diagnosis of carpal tunnel syndrome. J Am Acad Orthop Surg 2009;17:389-396.
  • Jackson DA, Clifford JC. Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys Med Rehabil 1989;70:199-204.
  • Uncini A, Lange DJ, Solomon M, Soliven B, Meer J, Lovelace RE. Ring finger testing in carpal tunnel syndrome: a comparative study of diagnostic utility. Muscle Nerve 1989;12:735-741.
  • Chen SF, Lu CH, Huang CR, et al. Ultrasonograph- ic median nerve cross-section areas measured by 8-point “inching test” for idiopathic carpal tunnel syn- drome: a correlation of nerve conduction study sever- ity and duration of clinical symptoms. BMC Med Imag- ing 2011;11:22-30.
  • Mackinnon SE. Pathophysiology of nerve compres- sion. Hand Clin 2002;18:231-241.
  • Yagihashi S. Recent advances in clinical practice and in basic research on diabetic neuropathy]. Brain Nerve 2011;63:571-582.
  • Thomsen NO, Mojaddidi M, Malik RA, Dahlin LB. Reduced myelinated nerve fibre and endoneurial capillary densities in the forearm of diabetic and non- diabetic patients with carpal tunnel syndrome. Acta Neuropathol 2009;118:785-791.
  • Hunderfund AN, Boon AJ, Mandrekar JN, Sorenson EJ Sonography in carpal tunnel syndrome. Muscle Nerve 2011;44:485-491.
  • Seror P. Sonography and electrodiagnosis in carpal tunnel syndrome diagnosis, an analysis of the litera- ture. Eur J Radiol 2008;67:146-152.
  • Jordan SE, Greider JL, Jr. Autonomic activity in the carpal tunnel syndrome. Orthop Rev 1987;16:165- 169.
  • Sugimoto H, Miyaji N, Ohsawa T (1994) Carpal tunnel syndrome: evaluation of median nerve circulation with dynamic contrast-enhanced MR imaging. Radiology 1994;190:459-466.
  • Şen TA, Bükülmez A, Köken R, et al. Tip 1 Diabetes Mellituslu Çocukların Retinal Doppler Ultrasonografi Bulguları ve Homosistein Düzeyleri. Güncel Pediatri 2008;6:19-25.
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ahmet Boyacı This is me

Ahmet Tutoğlu This is me

Nurefşan Boyacı This is me

İrfan Koca This is me

Dilek Şen Dokumacı This is me

Özcan Kocatürk This is me

Mehmet Ali Eren This is me

Ali Şakalar This is me

Publication Date June 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 2

Cite

APA Boyacı, A., Tutoğlu, A., Boyacı, N., Koca, İ., et al. (2014). Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri. Journal of Clinical and Experimental Investigations, 5(2), 179-185. https://doi.org/10.5799/ahinjs.01.2014.02.0386
AMA Boyacı A, Tutoğlu A, Boyacı N, Koca İ, Dokumacı DŞ, Kocatürk Ö, Eren MA, Şakalar A. Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri. J Clin Exp Invest. June 2014;5(2):179-185. doi:10.5799/ahinjs.01.2014.02.0386
Chicago Boyacı, Ahmet, Ahmet Tutoğlu, Nurefşan Boyacı, İrfan Koca, Dilek Şen Dokumacı, Özcan Kocatürk, Mehmet Ali Eren, and Ali Şakalar. “Diabetik Karpal tünel Sendromlu Hastalarda Radial Ve Ulnar Arterlerin akım Karakteristiklerinin değerlendirilmesi Ve Bu Hastalarda Ultrasonografinin tanısal değeri”. Journal of Clinical and Experimental Investigations 5, no. 2 (June 2014): 179-85. https://doi.org/10.5799/ahinjs.01.2014.02.0386.
EndNote Boyacı A, Tutoğlu A, Boyacı N, Koca İ, Dokumacı DŞ, Kocatürk Ö, Eren MA, Şakalar A (June 1, 2014) Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri. Journal of Clinical and Experimental Investigations 5 2 179–185.
IEEE A. Boyacı, “Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri”, J Clin Exp Invest, vol. 5, no. 2, pp. 179–185, 2014, doi: 10.5799/ahinjs.01.2014.02.0386.
ISNAD Boyacı, Ahmet et al. “Diabetik Karpal tünel Sendromlu Hastalarda Radial Ve Ulnar Arterlerin akım Karakteristiklerinin değerlendirilmesi Ve Bu Hastalarda Ultrasonografinin tanısal değeri”. Journal of Clinical and Experimental Investigations 5/2 (June 2014), 179-185. https://doi.org/10.5799/ahinjs.01.2014.02.0386.
JAMA Boyacı A, Tutoğlu A, Boyacı N, Koca İ, Dokumacı DŞ, Kocatürk Ö, Eren MA, Şakalar A. Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri. J Clin Exp Invest. 2014;5:179–185.
MLA Boyacı, Ahmet et al. “Diabetik Karpal tünel Sendromlu Hastalarda Radial Ve Ulnar Arterlerin akım Karakteristiklerinin değerlendirilmesi Ve Bu Hastalarda Ultrasonografinin tanısal değeri”. Journal of Clinical and Experimental Investigations, vol. 5, no. 2, 2014, pp. 179-85, doi:10.5799/ahinjs.01.2014.02.0386.
Vancouver Boyacı A, Tutoğlu A, Boyacı N, Koca İ, Dokumacı DŞ, Kocatürk Ö, Eren MA, Şakalar A. Diabetik karpal tünel sendromlu hastalarda radial ve ulnar arterlerin akım karakteristiklerinin değerlendirilmesi ve bu hastalarda ultrasonografinin tanısal değeri. J Clin Exp Invest. 2014;5(2):179-85.