Karpal Tünel Sendromunda Ultrasonografi ve Manyetik Rezonans Görüntülemenin Tanıya Katkıları

Giriş: Çalışmada; klinik ve elektrodiagnostik inceleme sonucu karpal tünel sendromu (KTS) tanısı alan hastalarda ultrasonografi (US) ve manyetik rezonans (MR) görüntülemenin tanıya katkısını değerlendirmek amaçlanmıştır.Hastalar ve Yöntem: KTS ön tanısı ile uygulanan elektromiyografi (EMG) incelemesi pozitif sonuçlanan 27 hastanın 41 el bileği, US ve MR ile tetkik edilmek üzere çalışmaya dahil edildi. El bileği bölgesini ilgilendiren geçirilmiş travma, operasyon ve steroid enjeksiyonu öyküsü olanlar çalışma dışı bırakıldı.Bulgular: Olguların yaş ortalaması 46,1 yıl olup %92,6’sı kadındı. Tutulum olguların 6’sında sağ, 7’sinde sol ve 14’ünde bilateral idi. US ile 41 el bileğinin %90,2’sinde, MR ile %92,7’sinde KTS’yi destekleyecek primer ve sekonder bulgular saptandı. Ayrıca iki olguda karpal kemiklerde dejeneratif kistik rezorpsiyon, bir olguda ganglion kisti ve bir olguda bifid median sinir varyasyonu tespit edildi. Sonuç: Klinik muayene ve/veya elektrodiagnostik tetkik ile KTS tanısı alan hastalarda US ve MR değerlendirmeleri; öngörülecek medikal veya cerrahi tedavi öncesinde gerek median sinirin hasarı ile ilişkili bulguları ortaya koyması gerekse yandaş anatomik ve patolojik durumları ortaya çıkarması yönünden yararlıdır.

Anahtar Kelimeler:

Karpal tünel sendromu, median sinir tuzak nöropatisi, ultrasonografi, manyetik rezonans görüntüleme, elektromiyografi

Contribution of Ultrasonography and Magnetic Resonance Imaging to the Diagnosis of Carpal Tunnel Syndrome

Objective: The present study aimed to evaluate the contribution of ultrasonography (US) and magnetic resonance (MR) imaging to the diagnosis of patients diagnosed with carpal tunnel syndrome (CTS) based on clinical and electrodiagnostic studies.Patients and Methods: A total of 41 wrists of 27 patients with positive findings in electromyography (EMG) studies performed due to a pre-diagnosis of CTS were included in the study to be examined by US and MR imaging. Patients with a history of wrist trauma, surgery, and steroid injection were excluded.Results: The mean age of the cases was 46.1 years and 92.6% of the cases were female. Of the patients, 6 had right-sided, 7 had left-sided, and 14 had bilateral CTS. Primary and secondary findings that support CTS were detected by US and MR imaging in 90.2% and 92.7% of the 41 wrists, respectively. Moreover, degenerative cystic resorption of the carpal bones was detected in two, ganglion cyst was detected in one, and bifid median nerve was detected in one case. Conclusion: US and MR imaging examinations in patients diagnosed with CTS based on clinical examination and/or electrodiagnostic studies are valuable in terms of both exhibiting the signs of median nerve injury and detecting concomitant anatomical and pathological conditions prior to the anticipated medical or surgical treatment.

Keywords:

Carpal tunnel syndrome, median nerve entrapment neuropathy, ultrasonography, magnetic resonance imaging, electromyography,

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