Öz
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.
Anahtar Kelimeler
Ultrasonography Carpal tunnel syndrome Shoulder pain Central sensitization
Kaynakça
- Başak Mansız Kaplan ( ) Physical Medicine and Rehabilitation Clinic, Ankara Training and Research Hospital, Ankara, Turkey e-mail: basakmansiz@hotmail.com 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
Öz
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
Anahtar Kelimeler
Karpal tünel sendromu Ultrasonografi Omuz ağrısı Santral sensitizasyon
Kaynakça
- Başak Mansız Kaplan ( ) Physical Medicine and Rehabilitation Clinic, Ankara Training and Research Hospital, Ankara, Turkey e-mail: basakmansiz@hotmail.com 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