Hand Volume as a Diagnostic Tool in Carpal Tunnel Syndrome

Abstract

Objectives: To determine whether patients with carpal tunnel syndrome have an objective swelling of their hands. Design: A prospective, cross-sectional study of consecutive patients. Setting: Two independent electromyographic laboratories. Participants: Sixty-three patients referred for electrodiagnostic work-up. Interventions: NCS/EMG testing and volumetric analysis. Limb volume was measured using the water displacement method using a volumeter. Main Outcome Measures: Differences in volume (DHV) and EMG/NCS data. Results: EMG results indicated that 24 subjects (38%) had findings consistent with CTS. Data concerning subjective swelling was available for only six of these 24 subjects. The data, which are limited by low power, indicate that there was no difference 1) between the volume of the affected hand and the unaffected hand among those with CTS; 2) between the DHV of those with CTS and those without;. 3) Patients with lower extremity complaints had significantly less DHV than those with an upper extremity complaint (p<0.0034, excluding patients with both upper and lower extremity complaints). Conclusions: Though a patients’ perception of hand swelling has previously been determined to be an indicator of CTS severity, there was no correlation found in this study between CTS and objective measures of swelling. However patients with an upper extremity complaints had a statistically larger DHV than those with a lower extremity complaint (p<0.0034), suggesting that objective swelling might be present under some unknown circumstances. As this study was limited by a low power, further investigation is warranted in this area.