Are extramedian symptoms associated with peripheral causes in patient with carpal tunnel syndrome? Electrodiagnostic and ultrasonographic study

Abstract

Objective: To evaluate the relationship between extramedian spreading of sensorial symptoms and median and ulnar nerve cross-sectional area (CSA) and to compare the ultrasonographic and electrophysiological findings in patients with carpal tunnel syndrome (CTS) with or without extramedian sensory symptoms. Design: Cross-sectional study. Materials and methods: Patients with CTS were divided into two groups as with or without extramedian symptoms and were assessed clinically, electrophysiologically and ultrasonographically by three blind investigators. In electrophysiological tests, median and ulnar nerve conduction studies were performed. Nerve cross-sectional areas were measured at hook of hamate, psiform bone, radio-ulnar joint, one-third distal part of forearm, and medial epicondyle by ultrasonography. Findings: The study was completed with 61 patients (108 hands). Extramedian symptoms were present in 31 patients (54 hands). Finger grip strength was lower, pain values evaluated with visual analogue scale were higher in patients with extramedian symptoms (p < 0.05). There was no statistically significant difference in electrophysiological and ultrasonographic parameters. Conclusion: According to our results, extramedian symptoms are not related to nerve conduction studies or nerve ultrasonography, these symptoms may be explained with central sensitization in patient with CTS. (C) 2017 Elsevier Ltd. All rights reserved.