Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: To compare the nerve cross sectional areas (CSA) in patients with RA without any sign of peripheral neuropathy to healthy controls.
Methods: The study group was generated from referrals to Rheumatic Diseases Outpatient Clinics. Clinical, electrophysiological and sonographic assessments were done by three blinded resarchers. Clinical assessment included Tinnel’s sign, Phalen test, tenar atrophy and Flick sign, KATZ hand diagram and Boston Questionnaire. Median, ulnar and tibial motor, median, ulnar and sural sensory nerve conduction studies (NCS) were performed. The patients who had an electrodiagnostic or clinical peripheral neuropathy were excluded from the study. Nerve CSA’s were measured in various levels; hamatum hook, psiform bone, radio-ulnar joint, distal 1/3 of forearm, and elbow levels for median nerve; radio-ulnar joint, psiform bone, distal 1/3 of forearm, and medial epicondyle for ulnar nerve. Three different measurements were obtained and the average measure was used for the each level.
Results: The study was completed with 30 women with RA and 30 healthy women. There were no statistical significance according to age, and body mass index. Despite both of the groups had no clinical and electrophysiological neuropathy, the sonographic measurements showed that median nerve CSA’s at radioulnar joint, psiform and hamatum levels of patients with RA were larger than healthy controls. Ulnar nerve CSA’s of all levels statistically increased in patients with RA (p<0.05). If the psiform level median nerve CSA>10 mm2 was used as sonographic carpal tunnel syndrome (CTS) criterion, 23/60 hands of 30 patients with RA and 5/60 hands of 30 healthy controls could be misdiagnosed as CTS.
Conclusion: Median and ulnar nerve CSA’s were larger than healthy control in patients with rheumatoid arthritis without clinical and electrophysiological peripheral neuropathy. The rheumatologists should be careful to diagnose CTS in patients with RA with using US.
Disclosure:
I. Yagci,
None;
M. Akdeniz Leblebicier,
None;
B. Mansiz Kaplan,
None;
D. Ozturk Gokbakan,
None;
G. Akyuz,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sonographic-measurements-can-be-misleading-for-diagnosing-carpal-tunel-syndrome-in-patients-with-rheumatoid-arthritis/