Comparison of high resolution ultrasonography and nerve conduction study in the diagnosis of carpal tunnel syndrome: diagnostic value of median nerve cross-sectional area

Carpal tunnel syndrome [CTS] is a common peripheral entrapment neuropathy. This study was performed to evaluate whether high-resolution ultrasonography may be an alternative diagnostic method for nerve conduction study [NCS] in the diagnosis of carpal tunnel syndrome. 132 wrists of 82 patients and 152 wrists of controls were enrolled in the study. The cross sectional area of the median nerve was measured at the carpal tunnel inlet and outlet in all patients and controls. All patients had a nerve conduction study. Then comparison between ultrasonography and NCS was performed. Combination of clinical diagnosis and NCS was used as the gold standard. The mean cross-sectional area [CSA] of the median nerve at the tunnel inlet was 11.4 +/- 1.7 mm[2] for the patient group and 5.78 +/- 0.9 mm[2] for the control group [P<0.001]. The mean cross-sectional area at the tunnel outlet was 9.9 +/- 1.2 mm[2] for the patient group and 4.7 +/- 0.7 mm[2] for the control group [P<0.001]. The best cut-off value of CSA at the tunnel inlet and the outlet was 7.5 mm[2]. In patients with clinical diagnosis of CTS we confirmed that the diagnostic value of ultrasonography is similar to NCS and sonography may be used in primary evaluation of CTS

[Report of a rare variation in ulnar nerve and its importance in surgery of carpal tunnel syndrome]

To report a variation in ulnar nerve and its importance in carpal tunnel syndrome surgery. The case is a patient that due to pain in carpal region and parasthesia in the second and third digits of both hands had referred. In physical examination there were phalan test and tinel sign. Electromyography [EMG] and Nerve Conducting [NC] confirmed the carpal tunnel syndrome and the surgery was conducted on the left hand. During surgery an aberrant branch found on retinaculum flexore that separated from ulnar nerve in Gugon's canal. The branch crossed with retinaculum flexor and then tended toward thenar muscles Forming a neuroma. Regarding the crossing of the aberrant branch with retinaculum flexor, it should be distinguished during releasing of retinaculum flexor in carpal tunnel syndrome surgery. Carelessness about this aberrant branch and its cutting leads to impairment of thumb movement

Merkel cell carcinoma, A case report and literature review

Merkel cell carcinoma is a rare tumor that develops on or just beneath the skin and hair follicles. It occurs most often on the face, head and neck. Early detection and treatment are important because the disease can spread rapidly. Merkel cell carcinoma is difficult to cure once it spreads. Researchers believe that exposure to sunlight may increase risk of this disease. Herein, we report a 70 - year - old female with a painful, nodular skin lesion of right leg that enlarged rapidly. Total excision was done. Pathologic findings confirmed diagnosis of Merkel cell carcinoma