AB1376 RELATIONSHIP BETWEEN INTRANEURAL HYPERVASCULARIZATION OF THE MEDIAN NERVE IN POWER DOPPLER AND ELECTROMYOGRAPHIC SEVERITY STAGES IN THE DIAGNOSIS OF SEVERITY OF CARPAL TUNNEL SYNDROME (PRELIMINARY RESULTS)

Abstract

BackgroundCarpal tunnel syndrome (CTS) is the most common tunnel syndrome in the upper limbs. Ultrasound has been increasingly used in recent years in the diagnosis of positive and severe CTS. Although the diagnosis of severity is essentially based on the ENMG, several studies have shown that ultrasound data can also constitute criteria for the severity of CTS.ObjectivesThe objective of our study is to evaluate the relationship between intraneural hypervascularization of the median nerve in power Doppler and the severity of CTS measured by ENMG.MethodsThis is a descriptive cross-sectional study of patients with clinically retained CTS. We excluded from the study operated patients and patients who received cortisone infiltration in the previous six months. All patients underwent ultrasound examination (B mode and Doppler mode) and electromyography one week apart. The severity stages of CTS have been defined according to the classification of Stevens (1997). The study is still ongoing.ResultsTo date we have included 14 patients with typical signs of CTS. 25 wrists were examined sonographically and by ENMG. The mean age of the patients was 54± 10 years. Bilateral SCC was present in 11 patients. Of the 25 affected wrists: 10, 7 and 8 were classified by the ENMG as mild, moderate and severe SCC respectively. On ultrasound, positive Doppler was found in 5 wrists (20% of wrists studied): Doppler was present in 10% of wrists with mild-stage SCC, 14.3% of wrists with moderate-stage SCC and in 37.5% of wrists with severe SCC. But this difference was not statistically significant (p=0.31) probably related to the small size of our current sample (study still ongoing).ConclusionThe preliminary results of our study suggest that intraneural hypervascularization of the median nerve in power Doppler could provide additional information on the severity of carpal tunnel syndrome. Results to be confirmed by the final results.References[1]Ghasemi-Esfe et All. Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity. Radiology 2011[2]Mohammadi A et All. Correlation between the severity of carpal tunnel syndrome and color Doppler sonography findings. AJR Am J Roentgenol 2012[3]Ghasemi-Esfe AR, Morteza A, Khalilzadeh O, Mazloumi M, GhasemiEsfe M, Rahmani M. Color Doppler ultrasound for evaluation of vasomotor activity in patients with carpal tunnel syndrome. Skeletal Radiol 2012; 41: 281-6Disclosure of InterestsNone declared