Dynamic Doppler Evaluation of the Radial and Ulnar Arteries in Patients With Carpal Tunnel Syndrome

Abstract

The objective of our study was to evaluate the blood flow characteristics of the radial and ulnar arteries of the hands of patients with carpal tunnel syndrome (CTS) either in the neutral position or in provocative positions using color Doppler imaging. Subjects with relevant complaints of CTS and positive Tinel sign and/or Phalen maneuver were recruited. Nerve conduction studies were performed to confirm the diagnosis of CTS. Forty-four hands of 22 patients with CTS (bilateral involvement) and 24 hands of 12 healthy volunteers were included in the study. Pulsed and color Doppler evaluations with the hands in the neutral, Phalen, and reverse Phalen positions were performed of the radial and ulnar arteries using a 5-13-MHZ linear-array transducer (Logiq 9). All of the CTS patients and control subjects were women; their mean ages were 50.77 ± 7.69 (SD) and 46.42 ± 4.32 years, respectively. When hands were evaluated in the neutral position, the flow volume, peak systolic velocity, end-diastolic velocity, and diameter values of both the radial and ulnar arteries were significantly greater in patients with CTS than in control subjects (all p < 0.05). When compared with the measurements obtained with hands at the neutral position, the decreases in the amount of blood flow during the Phalen and reverse Phalen maneuvers were significantly greater in the CTS group than the control group. The amount of blood flow decrease was not correlated with the disease duration. Blood flow in the hands of CTS patients differs from that of healthy individuals both at rest and during certain hand movements. Future studies, also with simultaneous monitoring of sympathetic innervation, could be beneficial to confirm the association between blood flow and the sympathetic nerves of the hand.