Journal of Hand Surgery (British and European Volume)

 

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Journal of Hand Surgery (British and European Volume), Vol. 18, No. 2, 176-179 (1993)
DOI: 10.1016/0266-7681(93)90100-T

Articles

The Use of Ultrasonography in Detection of Synovitis in Carpal Tunnel Syndrome

K. NAKAMICHI and S. TACHIBANA

From the Department of Orthopaedic Surgery, Torano-mon Hospital, Minato-ku, Tokyo, Japan

Correspondence: Dr K. Nakamichi, Department of Orthopaedic Surgery, Torano-mon Hospital, 2-2-2 Torano-mon, Minato-ku, Tokyo 105, Japan.

The findings of pre-operative ultrasonography of the carpal tunnel were compared with synovial histology in 50 surgically treated wrists with carpal tunnel syndrome. Eight wrists with a massive hypoechoic area (group 3) had synovitis. 28 with a minimal hypoechoic area (group 1) had no evidence of inflammation. 14 with a moderately increased hypoechoic area (group 2) consisted of three with synovitis, four with lymphocytic infiltration and seven without inflammation. Group 3 strongly indicates synovitis, in which case one should consider aetiology other than the idiopathic cause. Bilateral synovial thickening suggests carpal tunnel syndrome as the initial clinical picture of rheumatoid arthritis, and group 1 indicates idiopathic carpal tunnel syndrome provided that there are no primary causes.

  • BUCHBERGER W, SCHÖN G, STRASSER K, JUNGWIRTH W. High-resolution ultrasonography of the carpal tunnel Journal of Ultrasound in Medicine 1991 10531–537[Abstract]
  • FAITHFULL DK, MOIR DH, IRELAND J. The micropathology of the typical carpal tunnel syndrome Journal of Hand Surgery 1986 11B1131–132
  • FUCHS PC, NATHAN PA, MYERS LD. Synovial histology in carpal tunnel syndrome Journal of Hand Surgery 1991 16A4753–758[CrossRef][Medline] [Order article via Infotrieve]
  • MIDDLETON WD, KNEELAND JB, KELLMAN GM, CATES JD, SANGER JR, JESMANOWICZ A, FRONCISZ W, HYDE JS. MR imaging of the carpal tunnel: Normal anatomy and preliminary findings in the carpal tunnel syndrome American Journal of Roentgenology 1987 148307–316[Abstract/Free Full Text]
  • SCHUIND F, VENTURA M, PASTEELS JL. Idiopathic carpal tunnel syndrome: Histologic study of flexor tendon synovium Journal of Hand Surgery 1990 15A3497–503[CrossRef][Medline] [Order article via Infotrieve]
  • TACHIBANA S, MOMOI Y, TAKEMOTO T, NAKAMICHI K, INANAMI H. Histological study of synovium and ligament in carpal tunnel syndrome Journal of Japanese Society for Surgery of the Hand 1991 76979–982

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This Article
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