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Koç Yekedüz M, Köse E, İnci A, Yüksel MF, Doğulu N, Şen Akova B, Yeniay Süt N, Öncül Ü, Yildirim M, Fitoz S, Teber S, Tümer L, Eminoğlu FT. Is Ultrasonography a Reliable Approach for the Evaluation of Carpal Tunnel Syndrome in Patients With Mucopolysaccharidosis? Pediatr Neurol 2024; 155:171-176. [PMID: 38669799 DOI: 10.1016/j.pediatrneurol.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/09/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND One of the most common causes of carpal tunnel syndrome (CTS) in childhood is mucopolysaccharidosis (MPS). While ultrasonography (US) can aid in the diagnosis of CTS in adult patients, there is limited experience of this in the pediatric group. We aimed to investigate the results of wrist ultrasonography, which may be a candidate alternative to electrophysiological examination. METHODS The participants were evaluated for symptoms, physical examination findings, electrophysiological tests and grayscale US. CTS was diagnosed in accordance with the American Academy of Orthopedic Surgeons Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline. RESULTS Included in the study were 27 MPS patients aged 4.5-32 years and 30 healthy control subjects aged 4.3-26 years. Of the 54 wrists in the MPS group, 30 were diagnosed with CTS. The median cross-sectional area (CSA) at the proximal carpal tunnel, the CSA at the forearm, and the wrist-forearm ratio (WFR) were higher in the wrists of the MPS with CTS group than in those without CTS and the healthy control subjects. The WFR cutoff of ≥1.35, 56.6% (95% CI: 437.4-74.5) sensitivity, and 89.8% (95% CI: 81.0-95.5) specificity were consistent with a diagnosis of CTS (receiver operating characteristics analysis, area under the curve = 0.775, 95% CI: 0.673-0.877). CONCLUSION Although the US provides results with unsatisfactory specificity and sensitivity, it is a candidate for further investigation for the diagnosis of CTS because it is an innovative, noninvasive, and more accessible method. WFR value may produce more meaningful results than wrist or forearm nerve area measurements.
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Affiliation(s)
- Merve Koç Yekedüz
- Faculty of Medicine, Department of Pediatric Metabolism, Ankara University, Ankara, Turkey
| | - Engin Köse
- Faculty of Medicine, Department of Pediatric Metabolism, Ankara University, Ankara, Turkey; Ankara University Rare Diseases Application and Research Center, Ankara, Turkey.
| | - Aslı İnci
- Faculty of Medicine, Department of Pediatric Metabolism, Gazi University, Ankara, Turkey
| | - Merve Feyza Yüksel
- Faculty of Medicine, Department of Pediatric Neurology, Ankara University, Ankara, Turkey
| | - Neslihan Doğulu
- Faculty of Medicine, Department of Pediatric Metabolism, Ankara University, Ankara, Turkey
| | - Birsel Şen Akova
- Faculty of Medicine, Department of Pediatric Radiology, Ankara University, Ankara, Turkey
| | - Nurşah Yeniay Süt
- Faculty of Medicine, Department of Pediatric Neurology, Ankara University, Ankara, Turkey
| | - Ümmühan Öncül
- Faculty of Medicine, Department of Pediatric Metabolism, Ankara University, Ankara, Turkey
| | - Miraç Yildirim
- Faculty of Medicine, Department of Pediatric Neurology, Ankara University, Ankara, Turkey
| | - Suat Fitoz
- Faculty of Medicine, Department of Pediatric Radiology, Ankara University, Ankara, Turkey
| | - Serap Teber
- Faculty of Medicine, Department of Pediatric Neurology, Ankara University, Ankara, Turkey
| | - Leyla Tümer
- Faculty of Medicine, Department of Pediatric Metabolism, Gazi University, Ankara, Turkey
| | - Fatma Tuba Eminoğlu
- Faculty of Medicine, Department of Pediatric Metabolism, Ankara University, Ankara, Turkey; Ankara University Rare Diseases Application and Research Center, Ankara, Turkey
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Smart BD, Cartwright MS. Neuromuscular ultrasound as the sole diagnostic test for carpal tunnel syndrome in Hunter syndrome. Muscle Nerve 2021; 64:E9-E11. [PMID: 34050942 DOI: 10.1002/mus.27334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Benjamin D Smart
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Michael S Cartwright
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Coraci D, Cambise C, Maria Del Tedesco F, Santilli V, Padua L. Ultrasound findings of carpal tunnel syndrome in a hunter syndrome patient. Muscle Nerve 2016; 53:661-2. [PMID: 26789420 DOI: 10.1002/mus.25023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 12/23/2015] [Accepted: 12/26/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Daniele Coraci
- Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy.,Don Gnocchi Foundation, Milan, Italy
| | - Chiara Cambise
- Department of Geriatrics, Neurosciences and Orthopaedics, Universit` Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Maria Del Tedesco
- Department of Geriatrics, Neurosciences and Orthopaedics, Universit` Cattolica del Sacro Cuore, Rome, Italy
| | - Valter Santilli
- Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy.,Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy
| | - Luca Padua
- Don Gnocchi Foundation, Milan, Italy.,Department of Geriatrics, Neurosciences and Orthopaedics, Universit` Cattolica del Sacro Cuore, Rome, Italy
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