American Journal of Roentgenology, Vol 169, 1649-1653, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

Carpal tunnel syndrome: are the MR findings a result of population selection bias?

DM Radack, ME Schweitzer and J Taras
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

OBJECTIVE: Previous descriptions of MR imaging of carpal tunnel syndrome used limited study populations and volunteers as controls. We reevaluated these descriptions to determine their sensitivity and specificity when applied to a large consecutive clinical series in which the incidence of carpal tunnel syndrome was small. SUBJECTS AND METHODS: In 196 consecutive wrists for which supplemental axial conventional spin-echo T1-weighted and fast spin-echo T2-weighted images were obtained at 1.5 T with a dedicated wrist coil, 165 studies were available for review. Previously described signs of carpal tunnel syndrome such as proximally increased size, flattening of the median nerve, increased median nerve signal intensity, flexor tenosynovitis, retinacular bowing, decreased deep tendon fat, and deep palmar bursitis were retrospectively and independently evaluated by two observers who were unaware of patient diagnosis. RESULTS: None of the previously described signs was sensitive for the diagnosis of carpal tunnel syndrome. However, specificity was high for retinacular bowing (94%), median nerve flattening (97%), and deep palmar bursitis (95%). CONCLUSION: Most previously described MR imaging signs of carpal tunnel syndrome are insensitive and nonspecific. Exceptions include retinacular bowing, median nerve flattening, and deep palmar bursitis, which in our study proved to have specificities greater than or equal to 94%.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. Mallouhi, P. Pultzl, T. Trieb, H. Piza, and G. Bodner Predictors of Carpal Tunnel Syndrome: Accuracy of Gray-Scale and Color Doppler Sonography. Am. J. Roentgenol., May 1, 2006; 186(5): 1240 - 1245. [Abstract] [Full Text] [PDF]

				Y. M. El Miedany, S. A. Aty, and S. Ashour Ultrasonography versus nerve conduction study in patients with carpal tunnel syndrome: substantive or complementary tests? Rheumatology, July 1, 2004; 43(7): 887 - 895. [Abstract] [Full Text] [PDF]

				K. E. Chappell, M. D. Robson, A. Stonebridge-Foster, A. Glover, J. M. Allsop, A. D. Williams, A. H. Herlihy, J. Moss, P. Gishen, and G. M. Bydder Magic Angle Effects in MR Neurography AJNR Am. J. Neuroradiol., March 1, 2004; 25(3): 431 - 440. [Abstract] [Full Text] [PDF]

				J. G. Jarvik, E. Yuen, D. R. Haynor, C. M. Bradley, D. Fulton-Kehoe, T. Smith-Weller, R. Wu, M. Kliot, G. Kraft, L. Wang, et al. MR nerve imaging in a prospective cohort of patients with suspected carpal tunnel syndrome Neurology, June 11, 2002; 58(11): 1597 - 1602. [Abstract] [Full Text] [PDF]

				A. Kocharian, M. C. Adkins, K. K. Amrami, K. P. McGee, P. A. Rouleau, D. E. Wenger, R. L. Ehman, and J. P. Felmlee Wrist: Improved MR Imaging with Optimized Transmit-Receive Coil Design Radiology, June 1, 2002; 223(3): 870 - 876. [Abstract] [Full Text] [PDF]

				T. T. Miller, C. Martinoli, L. E. Derchi, and S. Bianchi Invited Commentary RadioGraphics, October 1, 2000; 20(90001): 213S - 217. [Full Text]

				P. J. Jenkins, S. A. Sohaib, S. Akker, R. R. Phillips, K. Spillane, J. A.H. Wass, J. P. Monson, A. B. Grossman, G. M. Besser, and R. H. Reznek The Pathology of Median Neuropathy in Acromegaly Ann Intern Med, August 1, 2000; 133(3): 197 - 201. [Abstract] [Full Text] [PDF]