Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Marschall, A; Ficjian, A; Stradner, MH; Husic, R; Zauner, D; Seel, W; Simmet, NE; Klammer, A; Heizer, P; Brickmann, K; Gretler, J; Fürst-Moazedi, FC; Thonhofer, R; Hermann, J; Graninger, WB; Quasthoff, S; Dejaco, C.
The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study.
PLoS One. 2016; 11(9):e0162288-e0162288
Doi: 10.1371/journal.pone.0162288
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- Führende Autor*innen der Med Uni Graz
- Stradner Martin Helmut
- Co-Autor*innen der Med Uni Graz
- Brickmann Kerstin
- Dejaco Christian
- Ficjan Anja
- Graninger Winfried
- Gretler Judith
- Hermann Josef
- Husic Rusmir
- Moazedi-Fürst Florentine
- Quasthoff Stefan
- Simmet Nicole
- Zauner Dorothea
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- Abstract:
- To investigate the prognostic value of B-mode and Power Doppler (PD) ultrasound of the median nerve for the short- and long-term clinical outcomes of patients with carpal tunnel syndrome (CTS). Prospective study of 135 patients with suspected CTS seen 3 times: at baseline, then at short-term (3 months) and long-term (15-36 months) follow-up. At baseline, the cross-sectional area (CSA) of the median nerve was measured with ultrasound at 4 levels on the forearm and wrist. PD signals were graded semi-quantitatively (0-3). Clinical outcomes were evaluated at each visit with the Boston Questionnaire (BQ) and the DASH Questionnaire, as well as visual analogue scales for the patient's assessment of pain (painVAS) and physician's global assessment (physVAS). The predictive values of baseline CSA and PD for clinical outcomes were determined with multivariate logistic regression models. Short-term and long-term follow-up data were available for 111 (82.2%) and 105 (77.8%) patients, respectively. There was a final diagnosis of CTS in 84 patients (125 wrists). Regression analysis revealed that the CSA, measured at the carpal tunnel inlet, predicted short-term clinical improvement according to BQ in CTS patients undergoing carpal tunnel surgery (OR 1.8, p = 0.05), but not in patients treated conservatively. Neither CSA nor PD assessments predicted short-term improvement of painVAS, physVAS or DASH, nor was any of the ultrasound parameters useful for the prediction of long-term clinical outcomes. Ultrasound assessment of the median nerve at the carpal tunnel inlet may predict short-term clinical improvement in CTS patients undergoing carpal tunnel release, but long-term outcomes are unrelated to ultrasound findings.