Median nerve strain and shear wave elastography in hypothyroid patients

Our study aimed to measure the elasticity of the median nerve in hypothyroid patients with carpal tunnel syndrome (CTS) symptoms using Strain (SE) and Shear wave (SWE) elastography methods and to sonoelastographically detect the increased frequency of CTS in hypothyroid patients by comparing it with the control group. In our study, 56 wrists of 28 patients were examined.Hypothyroidism patients aged 18-60 with CTS symptoms were included in our study.In the control group, 56 wrists of 28 patients were examined. The patients median nerve was detected under the flexor retinaculum at the proximal row carpal bone level, and median nerve cross-sectional area (MSCA) and stiffness were determined by SWE and SE. In the measurements made in the patient group, the average MSKA was measured as 0.1 ± 0.02 cm2 on the right and 0.09 ± 0.02 cm2 on the left.In the measurements made in the control group, the average MSKA was measured as 0.06 ± 0.01 cm2 on the right and left.MSCA was found to be significantly higher in hypothyroid patients than in the control group (p=0.001).We examined the SE patterns qualitatively between the two groups by categorizing them according to colors.In the hypothyroidism group, statistically significant stiffness was observed in SE patterns.The mean SWE value in kilopascals (kPA) was 69.19 ± 36.73 kPa on the right and 52.93 ± 26.73 kPA on the left axial plane in the patient group, while it was 18.94 ± 9.03 kPA on the right and 17.18 ± 7.64 kPA on the left in the axial plane in the control group.The mean SWE value in kPA was measured as 69.51 ± 32.29 kPA on the right and 56.2 ± 23.38 kPA on the left in the sagittal plane, and 17.63 ± 7.1 kPA on the right and 15.54 ± 6.16 kPA on the left in the control group.Median nerve SWE values were found to be significantly higher in the wrists of patients with hypothyroidism between the control group and the patient group (p=0.001). It has been shown that median nerve stiffness and cross-sectional area are increased in hypothyroid patients compared with healthy participants. In this study, it has shown that the frequency of CTS increases in hypothyroid patients, and it can be concluded that USG and sonoelastographic methods are promising imaging modalities in the diagnosis of CTS because they are repeatable, harmless and easily accessible.