Dilek KESKİN, Murathan KÖKSAL, S. Suha KOPARAL

KARPAL TÜNEL SENDROMU TANISINDA ULTROSONOGRAFİNİN TANI DEĞERİ

Median sinir ele osteofibröz bir kanal olan karpal tüneli geçerek girer. Karpal Tünel Sendromu(KTS) median sinirin karpal tünel içerisinde sıkışma (tuzak-entrapment) nöropatisi olup en sıkgörülen tuzak nöropatidir. KTS’ye nöroşirurji, ortopedi ve fizik tedavi pratiklerinde sıkça rastlanmaktadır.Sık görülmesi nedeniyle üzerine yoğun olarak çalışılması, klinik, elektrofizyolojik vetedavi açısından iyi tanımlanması gerekli olmuştur. Median sinirin karpal kanal içerisinde kompresyonusonucu elde median sinire uyan alanlarda özellikle geceleri ve tekrarlayan el bileğiaktiviteleri sonrasında belirginleşen parestezi ve ağrı yakınmaları ön plandadır. Bununla birliktegeç dönemde tenar kaslarda güçsüzlük ve atrofi görülebilir. Sonuçta kişinin günlük akviteleriniengelleyebilir. KTS tanısı hastanın hikayesi, klinik muayene ve EMG ile konur. Radyolojik görüntülemeyöntemleri (Direkt grafi, USG, BT ve MR) KTS’li bazı hastalarda kuşkulu patolojilerin açıklanmasındave karpal tünel patogenezinin anlaşılmasında yardımcı olmaktadır. Bu çalışmada,klinik olarak ve EMG ile KTS tanısı almış hastaların el bilekleri yüksek rezolüsyonluyüzeyel ultrasonografiile incelenerek, elde edilen bulgular klinik tanı ile karşılaştırıldı. Sonuçta, incelemezamam kısa, maliyeti düşük, ulaşılması kolay ve noninvaziv bir yöntem olan ultrasonografininKTS’deki tanı değeri araştırıldı.

Diagnostic Value of Ultrasonography in Carpal Tunnel Syndrome Diagnosis

Objectives: Median Nerve comes into hand by going through Carpal Tunnel which is an osteofibrous canal. Carpal Tunnel Syndrome (CTS) is the neuropathy of in carceration of median nerve in carpal tunnel, which is most commonly seen trap neuropathy. In this study, the wrists of patients who have been diagnosed as CTS by EMG and clinical way have been analysed by high resolusion superficial ultrasonography and the findings have been compared with clinical diagnosis. Material and Methods: 24 cases, having been diagnosed as CTS with EMG and clinically, 23 females and 1 male were evaluated by ultrosonography. In control group, 27 wrists selected randomly, were researched which don’t have any physical examination findings and any suffering related with CTS. Findings: In patients group the average crosssectional area of median nerve has been found as 0,1211 cm2 and faltting rate average has been found as 3,05. Moreover, in control group, the average cosssectional area of median nerve has been found as 0,0746 cm2 and flatting rate average has been found as 2,44. When these data have been compared statistically the values belong to crosssectional area of median nerve, transverse diameter and flatting rate don’t have any meaningful differences statistically between these two groups. Conclusion: Diagnosis value of ultrasoundography which has characteristics such as; time savinging in examining, low cost, easy to reach, and a noninvaziv method in CTS has been searched.

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