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1.
Rev. méd. Maule ; 36(2): 34-43, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1344612

ABSTRACT

Pain located in the lateral aspect of the elbow is a common cause of consultation in the trauma consultation. The most common cause is "lateral epicondylitis," however there are several differential diagnoses that may require different management. There is a case of radial tunnel syndrome secondary to extrinsic compression, with an emphasis on its diagnosis and surgical technique.


Subject(s)
Humans , Male , Middle Aged , Carpal Tunnel Syndrome/diagnosis , Radial Neuropathy/surgery , Radial Neuropathy/diagnosis , Nerve Compression Syndromes , Radial Nerve , Synovial Cyst/surgery , Magnetic Resonance Imaging , Combined Modality Therapy , Elbow , Elbow Joint , Pain Management , Injections, Intra-Articular , Neurologic Examination/methods
2.
Rev. méd. Chile ; 145(10): 1252-1258, oct. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902439

ABSTRACT

Background: Carpal tunnel syndrome (CTS) represents 90% of entrapment neuropathies. Severity may be greater in older patients. Aim: To describe the electrophysiological findings in adult patients with CTS and determine if severity is related to age. Material and Methods: Descriptive and retrospective study of electrophysiological findings in patients over 18 years of age with clinical suspicion of CTS, studied between January 2011 and December 2015. Neurophysiological severity was classified in 3 grades, comparing them by age, gender and laterality. Results: Of 1156 patients subjected to electrophysiological studies due to a clinical suspicion of CTS, 690 (60%) had electrophysiological features of the disease. In 274 patients (24%) the compromise was mild, in 162 (14%) it was moderate and in 254 (22%) it was severe. There was a positive association between age and CTS severity (p < 0.01). Severity was significantly greater in males than females (p < 0.01). Bilateral CTS was present in 471 patients (68%), which was associated with increased age and severity (p < 0.01). Conclusions: Electrophysiological severity in CTS increases with age. Other factors associated with higher severity are male gender and bilateral disease.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Severity of Illness Index , Carpal Tunnel Syndrome/physiopathology , Age Factors , Electromyography , Carpal Tunnel Syndrome/diagnosis , Sex Factors , Retrospective Studies , Median Nerve/physiopathology , Neural Conduction
3.
Rev. salud pública ; 19(4): 506-510, jul.-ago. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-903137

ABSTRACT

RESUMEN Objetivo Determinar la confiabilidad entre dos observadores y el cambio mínimo detectable de los estudios de neuroconducción para diagnosticar el síndrome de túnel carpiano. Métodos Se estudiaron 69 pacientes remitidos para estudio electrofisiológico por sospecha de síndrome de túnel carpiano. A los pacientes, se les realizaron dos exámenes, dos días diferentes, por dos evaluadores. Se evaluaron las latencias sensitivas y motoras de los nervios mediano y cubital; todos fueron clasificados como negativos, incipientes, leves, moderados, severos o extremos. Se calculó la variación relativa entre ensayos, el coeficiente de correlación intraclase, el índice de kappa, el límite de acuerdo y el cambio mínimo detectable. Resultados La variación relativa entre ensayos de la latencia motora del nervio mediano fue de -6,8 % a 15,9 % con coeficiente de correlación intraclase de 0,98 para la diferencia con la latencia del nervio cubital. El cambio mínimo detectable fue de 0,4ms. La variación relativa entre ensayos de la latencia sensitiva del nervio mediano fue -5,0 % a 11 % con coeficiente de correlación intraclase de 0,95 para la diferencia con el nervio cubital. El cambio mínimo detectable fue de 0,2ms. La clasificación ele trofisiológica coincidió en 93 % de los casos, índice de kappa de 0,89. Conclusiones Las latencias sensitivas y motoras del nervio mediano así como la diferencia de estas con el nervio cubital son medidas confiables. El cambio mínimo detectable obtenido en nuestro estudio le sirve al clínico para establecer si los cambios de las latencias en estudios consecutivos o después del tratamiento son significativos.(AU)


ABSTRACT Objective To determine the reliability of neuroconduction studies by comparing two observers and detecting minimum changes when diagnosing carpal tunnel syndrome. Methods Sixty-nine patients referred for electrophysiological study due to suspected carpal tunnel syndrome were studied. The patients underwent two examinations, performed by two evaluators, on two different days. Sensory and motor latencies of the median and ulnar nerves were evaluated; all were classified as negative, incipient, mild, moderate, severe or extreme. Relative interval variation, intraclass correlation coefficient, kappa index, limit of agreement and minimum detectable change were estimated. Results The relative variation of motor nerve latency of the median nerve was -6.8% to 15.9%, with intraclass correlation coefficient of 0.98 for the difference of median-ulnar nerve latency. The minimum detected change was 0.4ms, while the relative interval variation of sensory latency of the median nerve was -5.0% to 11%, with intraclass correlation coefficient of 0.95 for difference with the ulnar nerve. The minimum detectable change was 0.2ms. Electrophysiological classification agreed in 93% of the cases, with a kappa index of 0.89. Conclusions Sensory and motor latencies of the median nerve, as well as the difference between them and the ulnar nerve, are reliable measures. The minimum detectable change obtained in our study helps clinicians to establish whether changes in latencies in consecutive or post-treatment studies are significant.(AU)


Subject(s)
Humans , Carpal Tunnel Syndrome/diagnosis , Electrodiagnosis/instrumentation , Reproducibility of Results , Electrophysiological Phenomena , Correlation of Data
4.
Medicina (B.Aires) ; 76(4): 219-222, Aug. 2016. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-841580

ABSTRACT

El síndrome del túnel carpiano (STC) es una neuropatía por entrampamiento a nivel de la muñeca que cursa con dolor, parestesias y disestesias dolorosas. El diagnóstico electrofisiológico se basa en el estudio de la neuroconducción de las fibras gruesas. Nuestra hipótesis consiste en la existencia del compromiso de las fibras nerviosas finas y que este compromiso se correlaciona con el grado de gravedad. Se evaluaron retrospectivamente 69 manos correspondientes a 47 pacientes, varones y mujeres (edad media 53.8, rango 22-87 años) y como grupo contro, 21 manos correspondientes a los lados asintomáticos de estos casos. Se realizaron estudios de neuroconducción motora, sensitiva y ondas F para clasificar a las manos según el grado de gravedad. Se realizó el período silente cutáneo (PSC) en todas las manos. Se evaluaron latencias medias y duraciones medias del PSC. Las latencias medias se hallaron significativamente prolongadas en las manos con neuropatía (84.3 ± 16.3 mseg) con respecto a las manos sin neuropatía (74.8 ± 11.6 mseg), p < 0.05. Las latencias medias se hallaron más prolongadas en las manos con neuropatía de mayor gravedad (p < 0.05). En los 3 pacientes con neuropatía grado más grave no se halló el PSC. Se demostró el compromiso de las fibras finas A-delta en los pacientes con STC, con mayor compromiso a mayor severidad. El PSC puede usarse como complemento de los estudios de neuroconducción motora y sensitiva.


Carpal tunnel síndrome (CTS) is an entrapment neuropathy of the median nerve at the wrist, that leads to pain, paresthesia and painful dysesthesia. The electrophysiological diagnosis is based upon nerve conduction studies which evaluate thick nerve fibers. Our hypothesis is that there is an additional dysfunction of small fibers in CTS, which correlates with the degree of severity of the neuropathy. A retrospective study of 69 hands that belonged to 47 patients of both sexes (mean age 53.8, years, range 22-87) was performed, and, as a control group, 21 hands which corresponded to the asymptomatic side of those patients were evaluated. Motor and sensory conduction studies, as well as F-waves were performed to classify the neuropathy according to the degree of severity. Cutaneous silent period (CSP) was elicited in all hands. Mean onset latencies and durations of CSP were evaluated. Mean onset latencies were significantly prolonged in neuropathic hands (84.3 ± 16.3 msec) compared to asymptomatic hands (74.8 ± 11.6 msec) (p < 0.05). Mean latencies of the CSP were even prolonged (p < 0.05) in hands affected by a more severe neuropathy. In the 3 hands with most severe neuropathy, a CSP could not be elicited. In CTS an impairment of A-delta fibers was recorded through the CSP. The more severe the neuropathy is, the more impairment of A-delta fibers can be found. CSP may be assessed as a complement of motor and sensory nerve conduction studies in this neuropathy.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Carpal Tunnel Syndrome/diagnosis , Median Nerve , Nerve Fibers/physiology , Refractory Period, Electrophysiological , Carpal Tunnel Syndrome/physiopathology , Case-Control Studies , Retrospective Studies , Analysis of Variance , Statistics, Nonparametric , Neural Conduction/physiology , Neurologic Examination/methods
5.
Rev. cuba. ortop. traumatol ; 30(1): 40-52, ene.-jun. 2016. ilus, tab
Article in Spanish | LILACS, CUMED | ID: lil-794180

ABSTRACT

INTRODUCCIÓN: el síndrome del túnel del carpo constituye el diagnóstico más común para cirujanos de mano. Se han descrito diversos métodos quirúrgicos para su tratamiento, con reportes de buenos resultados. OBJETIVO: mostrar los resultados del tratamiento quirúrgico del síndrome del túnel del carpo, con empleo de anestesia local, incisión razonable y movilidad precoz en pacientes mayores de 65 años de edad. MÉTODO: estudio de intervención longitudinal prospectivo con pacientes mayores de 65 años de edad diagnosticados e intervenidos por síndrome del túnel del carpo entre el 1ro. de enero 2010 y el 1ro. de julio del 2014, y evaluados 1 año después de dicho tratamiento en el CITED. RESULTADOS: serie constituida por 194 pacientes, predominó el sexo femenino (81,44 %), se encontró asociación de síndrome del túnel del carpo con: realización de actividades manuales previas, posibilidad de afectación bilateral, antecedente de fractura de radio distal ipsilateral, comorbilidad con otras enfermedades como diabetes, artritis reumatoide y afecciones de tendones y sus vainas. La mejoría en síntomas, dolor y función al año fue superior al 98 %. CONCLUSIONES: el tratamiento quirúrgico del síndrome del túnel del carpo, con empleo de anestesia local, incisión de piel razonable y movilidad precoz, ocasiona significativa mejoría de los síntomas, del dolor y la función en adultos mayores de 65 años de edad.


INTRODUCTION: Carpal tunnel syndrome is the most common diagnosis for hand surgeons. They described various surgical methods for treatment, with reports of good results. OBJECTIVE: Show the results of surgical treatment of carpal tunnel syndrome using local anesthesia, reasonable incision and early mobility in patients older than 65 years old. METHOD: Prospective longitudinal intervention study with patients older than 65 years of age diagnosed and surgically treated for carpal tunnel syndrome from January 2010 to July 2014 and they were evaluated one year after treatment at CITED. RESULTS: In the series consisting of 194 patients, women predominated (81.44%). Association of carpal tunnel syndrome was found with holding prior manual activities, the possibility of bilateral involvement, history of fracture of ipsilateral distal radius, comorbidity with other diseases such as diabetes, rheumatoid arthritis and diseases of tendons. The improvement of symptoms, pain and function after a year was higher than 98%. CONCLUSIONS: Surgical treatment of carpal tunnel syndrome using local anesthesia, reasonable skin incision and early mobility causes significant improvement in symptoms, pain and function in adults older than 65 years old.


INTRODUCTION: Le syndrome du canal carpien est le diagnostic le plus souvent trouvé par les chirurgiens spécialisés en main. Plusieurs techniques chirurgicales ont été décrites pour son traitement, avec de très bons résultats. OBJECTIFS: Ce travail a le but de montrer les résultats du traitement chirurgical du syndrome du canal carpien à l'aide de l'anesthésie locale, d'une incision raisonnable et d'une mobilité précoce chez les patients âgés de plus de 65 ans. MÉTHODE: Une étude interventionnelle, longitudinale et prospective de patients âgés de plus de 65 ans, diagnostiqués et traités pour syndrome de canal carpien entre le 1er janvier 2010 et le 1er juillet 2014, et évalués un an après, a été effectuée au CITED. RÉSULTATS: Dans une série de 194 patients, où le sexe féminin était en majorité (81,44 %), on a trouvé que le syndrome du canal carpien était associé aux activités manuelles, à un possible trouble bilatéral, à une histoire de fractures du radius distal ipsilatéral, et à une comorbidité avec d'autres maladies telles que le diabète, l'arthrite rhumatoïde et les atteintes des tendons et leurs gaines. Les symptômes, la douleur et la fonction ont amélioré un an après l'opération dans 98 % de cas. CONCLUSIONS: En utilisant de l'anesthésie locale, une incision raisonnable et une mobilité précoce, le traitement chirurgical du syndrome du canal carpien entraîne une significative amélioration des symptômes, de la douleur et de la fonction chez les personnes âgées de plus de 65 ans.


Subject(s)
Humans , Aged , Carpal Tunnel Syndrome/surgery , Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/therapy , Anesthesia, Local , Prospective Studies , Longitudinal Studies , Clinical Trial
6.
Rev. Soc. Peru. Med. Interna ; 29(1): 14-21, ene.-mar.2016. tab
Article in Spanish | LILACS, LIPECS | ID: lil-786738

ABSTRACT

Describir las características clínicas de los pacientes con diagnostico electrofisiológico de Síndrome de Túnel del Carpo (STC) del Hospital Nacional Arzobispo Loayza (HNAL) en el periodo 2010-2011. METODO: Se realizó un estudio de tipo descriptivo de una serie de revisión de casos, donde se evaluaron 215 historias clínicas de pacientes con el diagnostico electrofisiológico de STC atendidos en consultorio de neurología del HNAL. Se registraron datos demográficos, datos clínicos, comorbilidades, datos de velocidad de conducción y de electromiografía. RESULTADOS: La media de la edad fue 51.97+/-12.08 años y el sexo femenino con 94.4% fue el más frecuente. El 100% presento dolor en las manos, el 41.4% presento parestesias, en la neuropatía del mediano bilateral el 93.35% presento tinel derecho, 83.05% presento tinel izquierdo, 67.8% presento phalen derecho, 64.97% presento phalen izquierdo. Las comorbilidades más frecuentes fueron Dislipidemia con 51.63%, Obesidad con 46.98% y Sobrepeso con 39.07%, con un promedio de Índice de Masa Corporal (IMC) de 29. 25+/-3.68 kg/m2. Por hallazgos electromiográficos el 64.4% de los pacientes presento neuropatía del mediano bilateral moderado, en los unilaterales 42.11 % presento neuropatía del mediano derecho leve, 10.53% presento neuropatía del mediano izquierdo leve. En el estudio de conducción nerviosa la media de la latencia sensitiva derecha fue 3.91+/-0.58ms, la latencia sensitiva izquierda de 3. 82+/-0.49ms, la latencia de conducción motora derecha de 4.7 1+/-0. 77ms, la latencia de conducción motora izquierda de 4. 56+/-0. 64ms. En la electromiografía la actividad de inserción del abductor corto del pulgar fue normal en el96. 7% del lado derecho, y 97.97% del lado izquierdo...


Describe the clinical features of patients with electrophysiological diagnosis of Carpal Tunnel Syndrome (CTS) at the Arzobispo Loayza National Hospital (HNAL) in the 2010-2011 period. MATERIAL AND METHODS: Descriptive study of a series of case review, where evaluated 215 medical charts of patients seen at the neurology ambulatory office of the HNAL with the electrophysiological diagnosis of CTS. Demographic data, clinical data, comorbidities, conduction velocity and electromyography were recorded. RESULTS: The mean age was 51 .97+/-1 2.08 years and the 94.4% were female. The pain in hand was found on 100%, the 41.4% had paresthesia, in the bilateral median neuropathy the 93.35% had right tinel, the 83.05% had left tinel, the 67.8% had right phalen, the 64.97% had left phalen. The most frequent comorbidities were Dyslipidemia on 51.63%, obesity on 46.98% and overweight on 39.07%, with a mean Body Mass index (BMI) of 29 kg/m2. The electromyography study found that 64.4% of patients had moderate bilateral median neuropathy, at the unilateral 42.11% had mild right median neuropathy, 10.53% had mild left median neuropathy. The mean right sensitive latency was 3.91+/-0.58ms, left sensitive latency was 3. 82+/-0.49ms, latency of right motor conduction was 4. 71+/-0. 77ms, and latency of left motor conduction was 4. 56+/-0. 64ms. The insertion activity of the short abductor of the thumb was normal on 96.7% on the right side, and 97.97% on the left side...


Subject(s)
Humans , Ambulatory Care , Electromyography , Carpal Tunnel Syndrome , Carpal Tunnel Syndrome/diagnosis , Epidemiology, Descriptive
7.
Acta ortop. bras ; 23(5): 244-246, Sep.-Oct. 2015.
Article in English | LILACS | ID: lil-762857

ABSTRACT

Objetivo: Demonstrar as características clínicas, epidemiológicas e osfatores de risco associados em pacientes portadores de Síndrome doTúnel do Carpo (STC) que estão em afastamento do trabalho, atendidosno ambulatório de Cirurgia da Mão de um Hospital Universitário. Métodos:Este é um estudo transversal realizado com os pacientes admitidossequencialmente acima de 18 anos de idade, sem distinção de gêneroe raça, no período entre setembro e novembro de 2014. Os pacientesincluídos responderam a um questionário e foram submetidos a examefísico criterioso pelos autores do trabalho. Resultados: Foram admitidos25 pacientes no período de três meses, todos do gênero feminino,com média de idade 50,24 anos (desvio padrão de 10,39). Dentreas profissões desempenhadas a prevalente foi a de serviços gerais/limpeza. A maioria apresentava obesidade, seguido por depressão ehipertensão arterial sistêmica. Aproximadamente metade dos pacientesencontrava-se em afastamento do trabalho. Distúrbios do sono foi umaqueixa comum dentre os entrevistados. Conclusão: A STC é uma causafrequente de afastamento do trabalho e está relacionada à obesidade,dislipidemia e depressão. Nível de Evidência IV, Série de Casos.


Objective: To report clinical and epidemiological characteristicsand risk factors of patients with Carpal Tunnel Syndrome(CTS) on sick leave admitted in a University Hospital.Methods: This is a transversal study conducted with patientsadmitted sequentially over 18 years of age, without distinctionof gender and race in the period between Septemberand November 2014. Patients answered a questionnaire andunderwent physical examination carried out by the authors.Results: Twenty-five patients were admitted within threemonths, all females, the mean age was 50.24 years old (standarddeviation 10,39) . Among the professions they performed,general and cleaning services were the most prevalent.Most patients featured obesity, followed by depression andsystemic arterial hypertension. Approximately half of themwere on sick leave. Sleep disorders were also a frequent complaint.Conclusion: CTS is a frequent cause of sick leave andit is related to obesity, dyslipidemia and depression. Level ofEvidence IV, Series of Cases.


Subject(s)
Humans , Female , Carpal Bones , Cross-Sectional Studies , Cumulative Trauma Disorders , Risk Factors , Carpal Tunnel Syndrome/diagnosis , Working Conditions
8.
Rev. bras. enferm ; 68(3): 414-420, maio-jun. 2015. tab
Article in Portuguese | LILACS, BDENF | ID: lil-756545

ABSTRACT

RESUMOObjetivos:verificar os itens componentes das contas hospitalares, conferidos por enfermeiros auditores, que mais recebem ajustes no momento da pré-análise; identificar o impacto dos ajustes no faturamento das contas analisadas por enfermeiros e médicos auditores e identificar as glosas relacionadas aos itens conferidos pela equipe de auditoria.Método:pesquisa quantitativa exploratória, descritiva, do tipo estudo de caso único.Resultados:após a análise de 2.613 contas constatou-se que o item mais incluído por enfermeiros foram gases (90,5%) e o mais excluído medicamentos de internação (41,2%). Materiais de hemodinâmica; gases e equipamentos foram os que mais impactaram nos ajustes positivos. Os ajustes negativos decorreram de lançamentos indevidos nas contas e não geraram prejuízos de faturamento. Do total de glosas 52,24% referiu-se à pré-análise dos enfermeiros e 47,76% a dos médicos.Conclusão:a presente investigação do processo de pré-análise fornece subsídios que contribuem para o avanço no conhecimento sobre a auditoria de contas hospitalares.


RESUMENObjetivos:comprobar los elementos que componen las cuentas del hospital, controladas por enfermeras auditores que reciben más ajustes en el momento de pre-análisis, identifi car el impacto de los ajustes a la facturación de las cuentas examinadas por las enfermeras y los médicos auditores; identifi car las glosas relacionadas con los puntos otorgados por equipo de auditoría.Método:estudio cuantitativo, exploratorio, descriptivo, tipo de investigación de caso único.Resultados:después de análisis de 2613 cuentas se encontró que el elemento más incluido por el enfermeros fue gas (90,5%) y lo más excluido fue hospitalización medicamentos (41,2%). Materiales de gases y equipos hemodinámicamente fueron los más afectados en los ajustes positivos. Los ajustes negativos fueron el resultado de errores en las cuentas y no generan pérdidas de ingresos. El rechazo total fue de 52,24% en relación a la pre-análisis de las enfermeras y de 47,76% de los médicos.Conclusión:esta investigación del proceso de preanálisis proporciona subsidios que contribuyen al avance de los conocimientos sobre la auditoría de las cuentas de los hospitales.


ABSTRACTObjectives:to determine which component items of hospital bills, examined by nurse auditors, were adjusted the most during pre-analysis; to identify the impact upon revenue caused by the adjustments to bills analyzed by physician and nurse auditors; and to identify disallowances related to items checked by the audit team.Method:quantitative, exploratory, descriptive, singlecase study.Results:after analysis of 2,613 bills, it was found that the item most included by nurses was gas (90.5%) and the most excluded was inpatient drugs (41.2%). Hemodynamics materials, gases and equipment had the greatest impact on upward adjustments. Downward adjustments were the result of improper entries on bills and did not generate revenue losses. Of total disallowances, 52.24% were related to the pre-analysis of nurses and 47.76% to that of physicians.Conclusion:this study of the pre-analysis process provides input that enhances knowledge about hospital bill audits.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Carpal Tunnel Syndrome/diagnosis , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Median Nerve/pathology , Wrist Joint/pathology , Area Under Curve , Carpal Tunnel Syndrome/pathology , Ligaments/pathology , ROC Curve , Sensitivity and Specificity
9.
JABHS-Journal of the Arab Board of Health Specializations. 2015; 16 (1): 17-21
in English | IMEMR | ID: emr-162153

ABSTRACT

Electrodiagnostic study has false positive and false negative results, moreover it is invasive and costly. This research aimed to evaluate if this study is obligatory before carpal tunnel release surgery in patients with clinically evident diagnosis, and if this study can predict surgical outcome. A prospective comparative study included 207 cases [mean age+/-standard deviation 42.35+/-11.19 years] diagnosed with carpal tunnel syndrome. One hundred cases had undergone confirmatory electrodiagnostic study [Group 1] while 107 had not [Group 2]. Patients in both groups were comparable for age, symptoms, duration of complaint, and physical findings. Both groups underwent open carpal tunnel release surgery and were evaluated two weeks and six months later by a physician not aware to which group the patient belonged. Response to surgery was comparable between the two groups [excellent in 91%, acceptable in 5.8%, and bad in 4.8% in the first vs. 87.9%, 5.6%, and 6.5% respectively in the second, p=0.493]. Electrodiagnostic study could be omitted in clinically evident carpal tunnel syndrome, even when patient is referred to surgery


Subject(s)
Humans , Female , Male , Adult , Middle Aged , Aged , Prospective Studies , Electrodiagnosis , Carpal Tunnel Syndrome/diagnosis
10.
Yonsei Medical Journal ; : 1015-1020, 2015.
Article in English | WPRIM | ID: wpr-150483

ABSTRACT

PURPOSE: Behcet's disease (BD) is a chronic inflammatory disease characterized by orogenital ulcers, skin and ocular lesions, in addition to articular, vascular, and neurologic symptoms. Carpal tunnel syndrome (CTS), can also occur in BD patients secondary to inflammation in the connective tissues, vessels, and tendons, as well as nerve involvement in BD itself. However, reports of patients who have CTS in BD are rare. The aim of this study was to evaluate the clinical characteristics of CTS in BD patients. MATERIALS AND METHODS: Retrospective analysis of the medical records of 1750 BD patients, and 14 (0.8%) BD patients who were diagnosed with CTS was performed at the BD Specialty Clinic of Severance Hospital. Patient demographics, disease activity/severity for both diseases, and the clinical characteristics of CTS in BD were recorded and analyzed. RESULTS: All 14 BD patients with CTS were women. Twelve patients (85.7%) were diagnosed with active BD. The CTS was mild in 8 patients (57.2%), moderate in 3 patients (21.4%), and severe in 3 patients (21.4%). Ten patients (71.4%) had BD prior to the diagnosis of CTS, and these 10 patients all had active BD. CONCLUSION: CTS can occur as a result of the inflammation associated with BD and can also be the presenting symptom of nerve involvement in BD. CTS can also develop as the initial symptom of BD. Therefore, a higher degree of suspicion should be maintained for CTS in patients with BD and vice versa; however, the exact relationship is uncertain.


Subject(s)
Adult , Age Distribution , Aged , Behcet Syndrome/complications , Carpal Tunnel Syndrome/diagnosis , Female , Humans , Inflammation , Male , Middle Aged , Retrospective Studies , Sex Distribution
12.
Rev. Hosp. Clin. Univ. Chile ; 26(2): 116-124, 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-786577

ABSTRACT

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the general population. In pregnant women the prevalence increases to 31-62 percent probably by edema secondary to the hormonal changes of pregnancy. The definitive treatment is surgical decompression, but in pregnant reserves only in exceptional cases where other treatments have failed. This population receives mainly conservative therapy consisting of splints, physical therapy and infiltration. Objective: To review the management of CTS in pregnant about a case. Methods: The clinical case of a pregnant patient with CTS managed conservatively was revised, based on this existing literature was reviewed. Results: 32 years old woman, studying 18 weeks pregnancy, consultation by paresthesia and loss of strength of both hands since1.5 months, more than right. Physical examination was consistent with bilateral CTS. Use of night splint is indicated. The electrodiagnostic evaluation reporting neuropathic sensitive-motor commitment severe intensity, subacute bilateral median nerve, with moderate denervation. Patient with symptoms persist, it is decided to perform infiltration of carpal tunnel steroid with good clinical and electrophysiological response. Conclusions: This case exemplifies the conservative treatment of CTS in pregnancy delivered good results. The literature supports the use of splints and steroid injections in this population...


Subject(s)
Humans , Female , Adult , Pregnancy Complications , Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/therapy
13.
Rev. bras. ortop ; 49(5): 429-436, Sep-Oct/2014.
Article in English | LILACS | ID: lil-727698

ABSTRACT

Carpal tunnel syndrome (CTS) is defined by compression of the median nerve in the wrist. It is the commonest of the compressive syndromes and its most frequent cause is idiopathic. Even though spontaneous regression is possible, the general rule is that the symptoms will worsen. The diagnosis is primarily clinical, from the symptoms and provocative tests. Elec-troneuromyographic examination may be recommended before the operation or in cases of occupational illnesses...


A sindrome do túnel do carpo (STC) é definida pela compressão do nervo mediano no punho. É a mais frequente das sindromes compressivas e a causa mais frequente é a idiopática. Ainda que as regressões espontâneas sejampossiveis, o agravamento dos sintomas é a regra. O diagnóstico é, acima de tudo, clinico pelos sintomas e testes provocativos. Um exame eletroneuromiográfico pode ser recomendado no pré-operatório ou em caso de doença laboral...


Subject(s)
Humans , Median Nerve , Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/etiology , Carpal Tunnel Syndrome/physiopathology
15.
Journal of Lasers in Medical Sciences. 2013; 4 (4): 182-189
in English | IMEMR | ID: emr-143076

ABSTRACT

Carpal Tunnel Syndrome [CTS] is the most common type of entrapment neuropathy. Conservative therapy is usually considered as the first step in the management of CTS. Low Level Laser Therapy [LLLT] is among the new physical modalities, which has shown therapeutic effects in CTS. The aim of the present study was to compare the effects of applying LASER and splinting together with splinting alone in patients with CTS. Fifty patients with mild and moderate CTS who met inclusion criteria were included in this study. The disease was confirmed by electrodiagnostic study [EDx] and clinical findings. Patients were randomly divided into 3 groups. Group A received LLLT and splinting. Group B received sham LLLT+ splinting and group C received only splints. Group A received LLLT [50 mw and 880nm with total dose of 6 joule/cm[2]]. Clinical and EDx parameters were evaluated before and after treatment [3 weeks and 2 months later]. Electrophysiologic parameters and clinical findings including CTS provocative tests, Symptoms severity score [SSS], Functional Severity Score [FSS] and Visual Analogue Score [VAS] were improved in all three groups at 3 weeks and 2 months after treatment. No significant changes were noticed between the three groups regarding clinical and EDX parameters. We found no superiority in applying Low Intensity Laser accompanying splinting to traditional treatment which means splinting alone in patients with CTS. However, future studies investigating LLLT with parameters other than the one used in this study may reveal different results in favor of LLLT.


Subject(s)
Humans , Nerve Compression Syndromes , Low-Level Light Therapy , Treatment Outcome , Electrodiagnosis , Carpal Tunnel Syndrome/diagnosis
16.
Pakistan Journal of Medical Sciences. 2013; 29 (1): 119-121
in English | IMEMR | ID: emr-127049

ABSTRACT

The aim of this study was to review the clinical characteristics and demography of Carpel Tunnel Syndrome [CTS] cases presented to a university hospital. A retrospective study was done for 336 consecutive patients [290 females and 46 males], referred with a clinical diagnosis of CTS to the Neuro-diagnostic laboratory at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2007 and December 2010. All subjects had clinical evaluation and standardized nerve conduction studies [672 hands] performed by the same examiner. Carpal tunnel syndrome was confirmed in 640 hands [95.23%] with female predominance [86.3%]. The mean age was 52.4 in females and 54.4 years in males with overall highest occurrence among the age group 45-< 55 years. Bilateral CTS was confirmed in the majority of the patients, i.e., 304 [90.5%], and remaining were unilateral. Among unilateral pattern, 22 [68.8%] had right CTS and others had left CTS. Most of the patients were treated conservatively 85.4% while the rest had surgical decompression 14.6%. Overall predominant age group was 45-<55 years with female dominancy. Majority of subjects had bilateral CTS as well as conservative treatment was frequent


Subject(s)
Humans , Male , Female , Carpal Tunnel Syndrome/diagnosis , Hospitals, Teaching , Retrospective Studies , Neural Conduction , Decompression, Surgical
17.
Rev. méd. Costa Rica Centroam ; 69(604): 523-528, oct.-dic. 2012.
Article in Spanish | LILACS | ID: lil-762536

ABSTRACT

El Síndrome del Túnel Carpal (CTS) es una de las neuropatías periféricas más comunes. Afecta principalmente a mujeres de edad media. En la mayoría de los pacientes la causa exacta y la patogénesis no está clara. Varias ocupaciones se han relacionado con aumento de la incididencia y prevalencia de CTS. El riesgo de CTS es alto en personas con ocupaciones que implican la exposición a alta presión, mucha fuerza, trabajo repetitivo, y herramientas que vibran. Los síntomas clásicos de CTS incluyen dolor nocturno asociado con hormigueo y entumecimiento en la distribución del nervio mediano. La prueba estándar de oro son los estudios de conducción nerviosa. El diagnóstico de CTS debe basarse en la anamnesis, exploración física y resultados de los estudios electrofisiológicos. El paciente con síntomas leves de CTS se puede controlar con tratamiento conservador. Sin embargo, en casos moderados a severos, la cirugía es el único tratamiento que ofrece cura.


Subject(s)
Humans , Carpal Tunnel Syndrome/surgery , Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/etiology , Carpal Tunnel Syndrome/therapy , Carpal Tunnel Syndrome
18.
Acta ortop. bras ; 19(5): 268-272, 2011. ilus, tab
Article in Portuguese | LILACS | ID: lil-608417

ABSTRACT

OBJETIVO: Descrever a utilização do PSSD (Pressure specified sensory device) para a realização do diagnóstico de Síndrome do Túnel do Carpo. MÉTODOS: O PSSD consiste de aparelho que incorpora um transdutor de pressão com duas extremidades rombas e com regulagem de distância entre elas, acoplado a um computador capaz de determinar os limiares cutâneos de pressão. Para tanto, os pacientes foram divididos em três grupos: Grupo 1- grupo controle, pacientes sem neuropatia no membro superior ou insuficiência renal. Grupo 2- pacientes com síndrome do túnel do carpo relacionada à hemodiálise. Grupo 3 - pacientes com síndrome do túnel do carpo sem insuficiência renal. RESULTADOS: Os resultados demonstraram haver um maior benefício do uso do PSSD para o diagnóstico da síndrome para os pacientes do grupo dois em dois dos quatro parâmetros avaliados quando comparados com os pacientes do grupo 3. CONCLUSÃO: O PSSD é útil para o diagnóstico da síndrome do túnel do carpo em pacientes hemodialíticos. Nível de Evidência II. Estudos diagnósticos.


OBJECTIVE: The aim of this study is to describe the use of the PSSD (Pressure specified sensory Device) for the diagnosis of carpal tunnel syndrome.METHODS: The PSSD is a tool that incorporates a pressure transducer with two prongs, linked to a computer capable of measuring the cutaneous pressure thresholds. The patients were divided in two groups: Group 1- patients neither with superior limb neuropathy nor renal insufficiency. Group 2- patients with carpal tunnel syndrome related to hemodialysis. Group 2 - patients with carpal tunnel syndrome but no renal insufficiency.RESULTS: The results showed, for two of the four parameters measured, that the group 2 had more benefits for the diagnosis of carpal tunnel syndrome than group 3.CONCLUSION: The PSSD is useful as a diagnostic tool in hemodialysis-related carpal tunnel syndrome Level of Evidence: Level II, development of diagnostic.


Subject(s)
Humans , Male , Female , Young Adult , Middle Aged , Electrodiagnosis/methods , Renal Dialysis , Carpal Tunnel Syndrome/diagnosis , Physical Examination , Surveys and Questionnaires , Transducers, Pressure
19.
Arq. neuropsiquiatr ; 68(1): 87-92, Feb. 2010. tab
Article in English | LILACS | ID: lil-541195

ABSTRACT

Objective: To establish nerve conduction parameters for carpal tunnel syndrome (CTS) electrodiagnosis in the elderly. Method: Thirty healthy subjects (65-86 years), 9 male and 21 female, were studied. Routine median and ulnar sensory and motor nerve conduction studies, median mixed palmar latency, comparative latency techniques median to ulnar (sensory, mixed and motor lumbrical-interossei), median to radial (sensory), and combined sensory index (CSI) were performed in both hands. Results: The upper limits of normality (97.5 percent) were: median sensory distal latency 3.80 ms (14 cm); median motor distal latency 4.30 ms (8 cm); median palmar latency 2.45 ms (8 cm); lumbrical-interossei latency difference 0.60 ms (8 cm); comparative median to radial 0.95 ms (10 cm); comparative median to ulnar 0.95 ms (14 cm); comparative palmar median to ulnar 0.50 ms (8 cm); and CSI 2.20 ms. Sensory and mixed latencies were measured at peak. Conclusion: Our results establish new nerve conduction parameters for mild CTS electrodiagnosis in the elderly and will be helpful to reduce the number of false positive cases in this age.


Objetivo: Estabelecer parâmetros de condução nervosa para o eletrodiagnóstico da síndrome do túnel do carpo (STC) em idosos. Método: Foram estudadas 30 pessoas idosas (65-86 anos) saudáveis. Foi realizado estudo de condução nervosa sensitiva e motora rotineira dos nervos mediano e ulnar, latência palmar mista do mediano, técnicas de comparação de latências mediano-ulnar (sensitivo, misto e motor lumbrical-interósseo) e mediano-radial (sensitivo) e índice sensitivo combinado (ISC) em ambas as mãos. Resultados: Os limites superiores de normalidade, 97,5 por cento foram: latência distal sensitiva do mediano 3,80 ms (14 cm); latência distal motora do mediano 4,30 ms (8 cm), latência palmar do mediano 2,45 ms (8 cm), diferença de latência lumbrical-interósseo 0,60 ms (8 cm), comparação mediano-radial 0,95 ms (10 cm), comparação mediano-ulnar 0,95 ms (14 cm), comparação mediano-ulnar palmar 0,50 ms (8 cm) e ISC 2,20 ms. As latências sensitivas e mistas foram medidas no pico. Conclusão: Nossos resultados estabelecem novos valores de condução nervosa para o eletrodiagnóstico da STC leve em idosos.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Brachial Plexus/physiology , Carpal Tunnel Syndrome/diagnosis , Neural Conduction/physiology , Sural Nerve/physiology , Reference Values , Reaction Time/physiology
20.
Bahrain Medical Bulletin. 2010; 32 (4): 161-163
in English | IMEMR | ID: emr-145176

ABSTRACT

The aim of this study is to review the spectrum of primary periarthropathies. Rheumatology clinic, Ibn Sina teaching hospital, Mosul, Iraq. Prospective non-experimental clinical study. Two hundred patients having primary periarthropathy were included in the study. Secondary cases of periarthropathy were excluded. Patients with multiple periarthropathy were recorded. Two hundred patients were studied, 114 were females and 33 were males who had one type of periarthropathy; the remaining had combinations of periarthropathies. The mean age for periarthropathy was more than 40, except for tendinitis [36.8 +/- 10.5]. The most common periarthropathies is the shoulder 93 [46.5%], followed by Carpal tunnel syndrome 57 [28.5%] and planter fasciitis 34 [17%], history was significantly high in these three conditions. Various combinations of periarthropathies were seen in the study group. Shoulder periarthropathies and CTS were the most common, 46.5% and 28.5% respectively. The concept of oligoarthropathy and possibly poly-periarthropathy needs further research. Constitutional factors, for example, gender and pro-inflammatory mechanisms need further studies


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Shoulder Joint/pathology , Carpal Tunnel Syndrome/diagnosis , Fasciitis/diagnosis , Prospective Studies , Bursitis/diagnosis
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