Abstract
BackgroundSystemic sclerosis can affect peripheral nerves, but the extent and the nature of this involvement are not well defined. The aim of this study is to compare the sonoelastrographic measurements of median nerves in systemic sclerosis (SSC), idiopathic carpal tunnel syndrome (CTS) and healthy individuals.MethodsThe clinical, electrophysiological and ultrasonographic assessments were done. Patients with SSC and CTS were assessed with nerve conduction studies. The measurements of cross sectional areas (CSA) were performed at psiform and forearm level from axial US images. The elastic ratio is the ratio of strain distribution in two selected region of interests (ROI) done via comparing the median nerve to flexor digitorum superfcialis tendon. The ROIs were fixed to 2 mm.ResultsThe study was completed with 47 hands of 24 patients with SSC, 53 hands of 27 patients with CTS and 38 hands of health controls. The CSA of CTS group was significantly higher than systemic sclerosis and control groups. The elastic ratio at psiform level and forearm levels of systemic sclerosis group were significantly higher than the CTS and control groups.ConclusionMedian nerves lose the elasticity while the CSA’s are in the normal range in patients with SSC. These results suggested that the increased peripheral nerve involvement in SSC is about the increased stiffness of the nerves.
Highlights
Systemic sclerosis can affect peripheral nerves, but the extent and the nature of this involvement are not well defined
Initially, 29 patients with systemic sclerosis (SSC), 27 patients with carpal tunnel syndrome (CTS) and 20 healthy controls were enrolled in the study
One patient in healthy subjects was excluded because of hereditary sensorimotor polyneuropathy according to nerve conduction study (NCS)
Summary
Systemic sclerosis can affect peripheral nerves, but the extent and the nature of this involvement are not well defined. The aim of this study is to compare the sonoelastrographic measurements of median nerves in systemic sclerosis (SSC), idiopathic carpal tunnel syndrome (CTS) and healthy individuals. Systemic sclerosis (SSC) is an autoimmune disease of unknown etiology that causes thickening in the connective tissues [1]. In a systematic review trigeminal neuropathy (16.5%), peripheral sensorimotor polyneuropathy (14.3%), and carpal tunnel syndrome (6.6%) were the most frequent forms of peripheral nervous system involvement in SSC [3]. Carpal tunnel syndrome (CTS) is the entrapment of median nerve under the flexor retinaculum. An increase in median nerve cross-sectional area and decreased echogenicity
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