TY - JOUR
T1 - Ultrasound assessment of the displacement and deformation of the median nerve in the human carpal tunnel with active finger motion
AU - Yoshii, Yuichi
AU - Villarraga, Hector R.
AU - Henderson, Jacqueline
AU - Zhao, Chunfeng
AU - An, Kai Nan
AU - Amadio, Peter C.
N1 - Funding Information:
In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases Grant AR49823. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.
Funding Information:
The project was supported by National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases Grant AR49823, and was performed in our Clinical Research Unit, which is supported by National Institutes of Health Grant RR024150.
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Background: Peripheral nerves are mobile structures, stretching and translating in response to changes in the position of adjuvant anatomic structures. The objective of this study was to develop a novel method to characterize the relative motion and deformation of the median nerve on cross-sectional ultrasound images of the carpal tunnel during active finger motion. Methods: Fifteen volunteers without a history of carpal tunnel syndrome or wrist trauma were recruited. An ultrasound scanner and a linear array transducer were used to evaluate the motion of the median nerve and the flexor tendons within the carpal tunnel duringmotion from full extension to full flexion by the four fingers (fist motion) and by the long finger alone. The displacement of the median nerve relative to the long-finger flexor digitorum superficialis tendon as well as the perimeter, cross-sectional area, circularity, and aspect ratio of a minimumenclosing rectangle of the median nerve were measured. The data were compared between single-digit motion and fist motion and between extension and flexion positions. Results: The distance between the long-finger flexor digitorum superficialis tendon and the median nerve with isolated long-finger flexion was decreased in the ulnar-radial direction and increased in the palmar-dorsal direction as compared with the distance with four-finger flexion (p < 0.01). Compared with the values with fist motion, the aspect ratio was decreased and the circularity was increased with long-finger motion (p < 0.01). Conclusions: This report presents a method with which to assess displacement and deformation of the median nerve on a cross-sectional ultrasound image during different finger motions. This method may be useful to assess pathological changes within the carpal tunnel, and we plan to perform a similar study of patients with carpal tunnel syndrome on the basis of these preliminary data. Level of Evidence: Diagnostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
AB - Background: Peripheral nerves are mobile structures, stretching and translating in response to changes in the position of adjuvant anatomic structures. The objective of this study was to develop a novel method to characterize the relative motion and deformation of the median nerve on cross-sectional ultrasound images of the carpal tunnel during active finger motion. Methods: Fifteen volunteers without a history of carpal tunnel syndrome or wrist trauma were recruited. An ultrasound scanner and a linear array transducer were used to evaluate the motion of the median nerve and the flexor tendons within the carpal tunnel duringmotion from full extension to full flexion by the four fingers (fist motion) and by the long finger alone. The displacement of the median nerve relative to the long-finger flexor digitorum superficialis tendon as well as the perimeter, cross-sectional area, circularity, and aspect ratio of a minimumenclosing rectangle of the median nerve were measured. The data were compared between single-digit motion and fist motion and between extension and flexion positions. Results: The distance between the long-finger flexor digitorum superficialis tendon and the median nerve with isolated long-finger flexion was decreased in the ulnar-radial direction and increased in the palmar-dorsal direction as compared with the distance with four-finger flexion (p < 0.01). Compared with the values with fist motion, the aspect ratio was decreased and the circularity was increased with long-finger motion (p < 0.01). Conclusions: This report presents a method with which to assess displacement and deformation of the median nerve on a cross-sectional ultrasound image during different finger motions. This method may be useful to assess pathological changes within the carpal tunnel, and we plan to perform a similar study of patients with carpal tunnel syndrome on the basis of these preliminary data. Level of Evidence: Diagnostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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U2 - 10.2106/JBJS.H.01653
DO - 10.2106/JBJS.H.01653
M3 - Article
C2 - 19952256
AN - SCOPUS:73349106832
SN - 0021-9355
VL - 91
SP - 2922
EP - 2930
JO - Journal of Bone and Joint Surgery
JF - Journal of Bone and Joint Surgery
IS - 12
ER -