Ultrasound assessment of carpal tunnel in rheumatoid arthritis and idiopathic carpal tunnel syndrome.
Gianluca SmerilliAndrea Di MatteoEdoardo CipollettaSergio CarloniAntonella IncorvaiaMarco Di CarloWalter GrassiEmilio FilippucciPublished in: Clinical rheumatology (2020)
The sonographic spectrum of CTS in RA patients is characterized by an inflammatory pattern, defined by the presence of finger flexor tendons tenosynovitis and/or radio-carpal joint synovitis. Conversely, a marked median nerve swelling is the dominant feature in idiopathic CTS. Intraneural PD signal is a frequent finding in both conditions. Key Points • Carpal tunnel syndrome (CTS) associated with rheumatoid arthritis (RA) and idiopathic CTS have distinct ultrasound patterns. • The most characteristic sonographic features of CTS in RA patients are those indicative of synovial tissue inflammation at carpal tunnel level. Conversely, marked median nerve swelling is the dominant finding in idiopathic CTS. • Intraneural power Doppler signal is a frequent finding in both conditions. • In patients with CTS, differently from electrophysiology, US can provide clues prompting a rheumatology referral in case of prominent inflammatory findings at carpal tunnel level.
Keyphrases
- rheumatoid arthritis
- end stage renal disease
- newly diagnosed
- ejection fraction
- disease activity
- oxidative stress
- chronic kidney disease
- magnetic resonance imaging
- ankylosing spondylitis
- peritoneal dialysis
- machine learning
- interstitial lung disease
- patient reported outcomes
- systemic lupus erythematosus
- ultrasound guided
- deep learning
- optical coherence tomography
- computed tomography