Presented to the European Federation of Neurological Societies Congress, September 9–12, 2012, Stockholm, Sweden.
Konstantinos Chiotis, MD
Archives of Physical Medicine and Rehabilitation
Volume 94, Issue 4 , Pages 737-744, April 2013

Abstract

Objective

To investigate the possible association of external and ultrasonographic measurements of the hand and wrist with median nerve conduction studies.

Design

Two group comparison study.

Setting

Outpatient neurophysiology laboratory and radiology department in a university hospital.

Participants

Patient group (n=50; 40 women) with clinically overt and electrophysiologically proven idiopathic carpal tunnel syndrome and a control group of age- and sex-matched healthy volunteers (n=50).

Interventions

Not applicable.

Main Outcome Measures

The following measurements were taken: (1) motor and sensory conduction studies of the median nerve; (2) external hand and wrist dimensions (hand ratio and wrist ratio); and (3) ultrasonographic dimensions of the carpal tunnel (carpal tunnel inlet ratio and carpal tunnel outlet ratio) and inlet cross-sectional area and outlet cross-sectional area of the median nerve at the tunnel.

Results

Differences between patients and controls were significant for hand and wrist ratios and all ultrasonographic dimensions. Sensory conduction velocity and distal motor latency of the median nerve in all 100 subjects were well correlated with hand ratio, wrist ratio, carpal tunnel inlet ratio, and carpal tunnel outlet ratio estimates. Wrist ratio was significantly correlated with carpal tunnel inlet ratio and carpal tunnel outlet ratio.

Conclusions

A particular hand and wrist configuration, that is, short and wide hand with square wrist matching to narrow and deep tunnel entrance demonstrated increased liability for idiopathic carpal tunnel syndrome. For screening purposes, it was suggested that simple external hand or wrist measurements could be used to predict the tendency for carpal tunnel syndrome.