Role of ultrasound in diagnosis of Carpal Tunnel Syndrome in diabetic patients

Abstract

Objective: To detect the musculoskeletal disorders of diabetes affecting the hand by ultrasonography (US) and to study the relationship of these changes with the arterial Doppler blood flow pattern. Materials & Methods: Both hands of 23 diabetic patients (age 53 ± 11.3 years) (10 female, 13 male) were examined by US and compared to age and sex matched control group (age 53 ± 11.1 years). Median nerve diameters, area and circumference measurements, flexor retinaculum thickness and tendinopathic changes as decrease in echogenicity, peritendinous fluid collection were studied. Arterial Doppler echo pattern of radial, ulnar and palmar arch arteries have also been studied. Clinical findings as arthralgia, numbness and limited joint mobility were recorded. Results: Patients group showed a significant increase (P<0.01) in median nerve diameters (3.8 × 5.1 mm), area (15.5 ± 5.1 mm²), circumference (14.3 ± 2.4 mm) and flexor retinaculum (FR) thickness measurements (2.1 ± 0.3 mm), compared with the control group values (2.7 × 4.0 mm, 8.7 ± 1.9 mm², 11.1 ± 1.3 mm, 1.7 ± 0.1 mm, respectively). Monophasic arterial flow pattern was seen in 28 out of 46 hands and revealed a significant correlation with FR thickness, decreased tendon echogenicity, peritendinous fluid collection and HbA1c. Clinical findings were also significantly correlated with arterial monophasic flow pattern, FR thickness, peritendinous fluid, median nerve diameters, area, and circumference measurements. Conclusion: We can evaluate the diabetic hand by US and the arterial flow pattern can be used as a predicting factor for the possible changes in the future. Introduction Diabetes mellitus (DM) is a chronic and prog>