An evaluation of radial and ulnar artery flow characteristics in diabetic patients with carpal tunnel syndrome and the diagnostic value of ultrasonography in these patients
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Ahmet Boyacı 1 * , Ahmet Tutoğlu, Nurefşan Boyacı, İrfan Koca, Dilek Şen Dokumacı, Özcan Kocatürk, Mehmet Ali Eren, Ali Şakalar
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1 Harran Üniversitesi Tıp Fakültesi, Fiziksel Tıp Ve Rehabilitasyon Ana Bilim Dalı, Şanlıurfa, Turkey* Corresponding Author

Abstract

Objectives: This study aimed to research the value of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS) in patients with diabetes mellitus (DM) and to examine the flow characteristics of the radial and ulnar arteries in diabetic patients with CTS.
Methods: A total of 23 diabetic hands diagnosed with CTS from electrophysiological evaluation (DM-CTS), 47 asymptomatic diabetic hands (DM) and 50 healthy hands (C) as the control group were evaluated with high resolution ultrasonography. The median nerve was measured in the cross-sectional area (CSA), flattening ratio (FR) and at the level of the carpal tunnel inlet [proximal (p)] and the wrist crease [distal (d)]. The radial and ulnar arteries were evaluated with both hands in a neutral position.
Results: In the DM-CTS group, the CSA-p and CSA-d values were statistically signficantly greater compared to the DM and C groups (p<0.01). The FR-p in the DM-CTS group was statistically significantly greater than that of the C groups (p<0.01). In the ROC curve analysis, CSA-p ≥ 9.5 mm2 (AUC 0.84; sensitivity 78.3% and specificity 88%) and CSA-d ≥ 9.5 mm2 (AUC 0.78; sensitivity 73.9% and specificity 84%) were very strong predictors of the DM-CTS hand. In the Doppler examination, no difference was determined between the groups in terms of flow volume, peak systolic velocity, end-diastolic velocity and resistive index measurements of both radial and ulnar arteries (p>0.05). The radial artery diameter was determined to be statistically significantly greater in the DM-CTS group than the C group (p<0.05).
Conclusion: The median nerve CSA is significantly greater in diabetic CTS patients compared to patients with diabetes only and healthy controls. In the evaluation of CTS in diabetic patients, CSA measured with ultrasonography may be a diagnostic tool.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Research Article

J Clin Exp Invest, Volume 5, Issue 2, June 2014, 179-185

https://doi.org/10.5799/ahinjs.01.2014.02.0386

Publication date: 11 Jun 2014

Article Views: 2511

Article Downloads: 1478

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