Evaluation of the relationship between clinical, electroneuromyographic, ultrasonographic findings and body mass index in patients with carpal tunnel syndrome

Evaluation of the Relationship Between Clinical, Electroneuromyographic, Ultrasonographic Findings and Body Mass Index in Patients with Carpal Tunnel Syndrome Introduction: Carpal tunnel syndrome is the trapping of the median nerve in the carpal tunnel at the level of the wrist which is the most common mononeuropathy and trap neuropathy. Although its etiology is mostly idiopathic, obesity is known to increase the incidence of CTS. Nowadays, the method used to diagnose and stage CTS is electrophysiological studies. The aim of this study is examine the relationship between body mass index and CTS symptoms and patients' functionality and the place of ultrasonography in CTS diagnosis and staging. Materials and Methods: A total 98 patients who were admitted to the clinic of Hacettepe University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, diagnosed with CTS using electrophysiological methods according to the criteria of AAPMR (American Academy of Physical Medicine and Rehabilitation) were included in the study. Patients' age, gender, dominant hand, symptomatic hand, duration of symptoms and the hand that is evaluated in this study were recorded. Detailed height and weight measurements were evaluated. The severity of pain was assessed by VAS (Visual Analogue Scale), symptom severity and functional status by the BCTSQ (Boston Carpal Tunnel Syndrome Questionnaire). The median nerve transverse cross-sectional area (CSA) was measured ultrasonographically. Results: 98 patients were divided into 3 groups as normal, pre-obese and obese according to the obesity classification of the World Health Organization by calculating body mass indexes. In our study, no significant difference was observed between patients' VAS, BCTSQ symptom severity score and ultrasonographic median nerve CSA measurements, whereas BCTSQ functional status score was found to be proportional to body mass index increase. 98 patients included in the study were divided into 3 groups as mild, moderate and severe by evaluating EMG findings. When these 3 groups were compared, a statistically significant difference was observed between the disease stage and VAS, BCTSQ symptom severity and functional status score and ultrasonic median nerve CSA measurements. Conclusion: Although there is no significant difference between body mass index and CTS disease severity and clinical status of patients, a significant difference has been observed in terms of disease severity and ultrasonographic evaluation, and it has been demonstrated that ultrasonography may have a place in CTS diagnosis and staging. Key words: Carpal tunnel syndrome, obesity, ultrasonography