Abstract
ObjectivesThis study aimed to determine the frequency of occurrence of carpal tunnel syndrome (CTS) in rheumatoid arthritis (RA) patients, determine its relation to disease activity, describe the ultrasonographic (US) finding of CTS, and compare the diagnostic value of US with the electrodiagnosis in the detection of CTS.Patients and methodsThis study was carried out on 54 adult RA patients (group II) compared with 20 healthy volunteers as controls (group I). The disease activity in all patients was assessed using DAS28. All patients and controls underwent complete rheumatological and neurological examinations. Nerve conduction study (NCS) and high-resolution sonography were assessed in a blinded manner to clinical data. The patients were subdivided into two groups according to the measurement of NCS (group IIA: RA patients with CTS and group IIB: RA patients without CTS).ResultsThe frequency of CTS in RA patients was 40.7%. A strong positive correlation was found between group IIA and the disease activity scale (P < 0.0001). There was a significantly higher level of cross-sectional area at the carpal tunnel inlet in group IIA than in group IIB and the control group (P < 0.0001). There was a significant correlation between the mean cross-sectional area with the grades of CTS detected by the electrophysiological study. The area under the curve was large for all receiver operating characteristic curves for each measurement (0.800).ConclusionThe frequency of CTS in RA patents is high. High-frequency US examination of the median nerve should be strongly considered as a new alternative diagnostic modality for the evaluation of CTS. Sonography is probably preferable because it is painless, fast, easily accessible, and preferred by the patients.
Highlights
Rheumatoid arthritis (RA) is a systemic inflammatory disease of unknown etiology characterized by the involvement of the joints
The preliminary criteria for clinical remission in RA were used to evaluate the remission of the patients and the results showed that four of the patients were in remission [10].Assessment of disability of RA patients was performed by health assessment quetionairre (HAQ)
The RA patients were subdivided into two groups; the first one, group IIA, inlcuded RA patients with carpal tunnel syndrome (CTS), and the second one, group IIB, included RA patients without CTS according to the measurement of the nerve conduction study
Summary
Rheumatoid arthritis (RA) is a systemic inflammatory disease of unknown etiology characterized by the involvement of the joints. Carpal tunnel syndrome (CTS) is the most common form of entrapment neuropathies, and the prototypical injury of the median nerve at the wrist is either an acute or a chronic compressive lesion. It is usually diagnosed by electrodiagnostic studies and clinical findings are variable and include symptoms of burning pain, tingling, numbness, and weakness or atrophy in the hands of the patients [3]. The most reliable method to confirm the clinical diagnosis of CTS is electrodiagnostic testing, but false negatives and false positives may occur, even when the most sensitive methods are used [4,5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
