Ultrasonographic assessment of the shoulder in patients with carpal tunnel syndrome

102 - 109, 15.05.2016

Başak Mansız Kaplan , İlker Yağcı Merve Akdeniz Leblebicier

https://doi.org/10.5472/MMJoa.2902.07

Abstract

Objectives: To detect the causes of shoulder pain with shoulder

ultrasonography in patients with carpal tunnel syndrome (CTS)

and compare the findings of the patients with CTS to healthy

controls.

Patients and Methods: Patients with CTS and healthy

controls were evaluated clinically, electrophysiologically,

and ultrasonographically by three masked researchers.

Electrophysiological assessment consisted median and ulnar nerve

conduction studies (NCS). In ultrasonographic assessment, crosssectional

areas of the median nerve were measured at hamatum

hook, psiform bone, radio-ulnar joint levels. Shoulder joint, axial

and longitudinal biceps tendon, subscapularis tendon, supraspinatus

tendon, infraspinatus tendon, rotator cuff, acromioclavicular joint

were evaluated by a standardized protocol.

Results: The study was completed with 30 patients with CTS

and 30 healthy subjects. The presence of shoulder pain in the last

week was 53.3% in the CTS group and 30% in the control group

but there was no statistically significant difference between the

groups (p=0.16; p>0.05). Subdeltoid bursitis was significantly

more common in CTS group when compared to the control group

(p=0.03) in ultrasonographic assessment, and there was no

significant difference between the two groups for other parameters.

Conclusion: Shoulder pain and subdeltoid bursitis were

common in patients with CTS however, shoulder pain was not

directly related to shoulder problems alone. Central sensitization

may play a role for shoulder pain rather than shoulder problems.

Keywords

Ultrasonography, Carpal tunnel syndrome, Shoulder pain, Central sensitization

Karpal tünel sendromlu hastaların omuzlarının ultrasonografik olarak değerlendirilmesi

Abstract

Amaç: Karpal tünel sendromlu (KTS) hastalarda omuz ağrısı nedenlerini omuz ultrasonografisi ile saptamak ve KTS’li hastaların değerlerini kontrol grubu değerleri ile karşılaştırmak.Hastalar ve Yöntem: KTS’li hastalar ve kontrol grubu klinik, elektrofizyolojik ve ultrasonografik olarak üç kör araştırmacı tarafından değerlendirildi. Elektrofizyolojik olarak median ve ulnar sinir iletim çalışmaları yapıldı. Ultrasonografik değerlendirmede median sinir kesitsel alan ölçümleri hamatum çengeli, psiform kemik ve radioulnar eklem mesafesinden ölçüldü. Omuz eklemi, biseps, subskapularis, supraspinatus, infraspinatus tendonları, rotator manşon ve akromyoklavikular eklem standart bir yaklaşımla değerlendirildi. Bulgular: Çalışma 30 KTS ve 30 kontrol grubu hastasıyla tamamlandı. KTS’li hastalarda omuz ağrısı sıklığı %53.3 iken kontrol grubunda %30 bulundu, istatistiksel fark saptanmadı (p=0.16; p>0.05). KTS’li hastalarda ultrasonografik olarak subdeltoid bursit anlamlı olarak fazla iken (p=0.03) diğer parametreler için her iki grup arasında fark saptanmadı. Sonuç: KTS’li hastalarda omuz ağrısı ve subdeltoid bursit sık görülmesine rağmen omuz ağrısı tek başına bu bulguya dayanmamaktadır. Omuz ağrısının santral sensitizasyon mekanizmaları ile gelişmesi muhtemeldir

Keywords

Karpal tünel sendromu, Ultrasonografi, Omuz ağrısı, Santral sensitizasyon

References

• Başak Mansız Kaplan ( ) Physical Medicine and Rehabilitation Clinic, Ankara Training and Research Hospital, Ankara, Turkey e-mail: [e-mail] İlker Yağcı Department of Physical Therapy and Rehabilitation, School of Medicine, Marmara University, Training and Research Hospital, Pendik, Istanbul, Turkey Merve Akdeniz Leblebiciler Physical Medicine and Rehabilitation Clinic, Gümüşhane State Hospital, Gümüşhane, Turkey