Assessment of Carpal Tunnel Syndrome in Patients With Wrist Involvement During the Course of Inflammatory Arthritis. A Cross-Sectional Study.

IF 1.5 Q3 RHEUMATOLOGY

Musculoskeletal Care Pub Date : 2025-03-01 DOI:10.1002/msc.70063

Fabio Massimo Perrotta, Marcella Antenucci, Marcello Zappia, Ennio Lubrano

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引用次数: 0

Abstract

Aim: The aim of the study was to evaluate the ultrasonographic (United States) alterations of the median nerve, the performance of the Kamath screening questionnaire and the clinical examination (Tinel and Phanel test) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) with previous or present inflammatory involvement of the radio-ulno-carpal joint.

Patients and methods: A cross-sectional study was carried out. Patients with RA and PsA and clinical symptoms suggestive of CTS were consecutively recruited. The main clinical-demographic characteristics were collected in all patients. The Kamath questionnaire was administered to all patients during the clinic visit. The US examination was used as a 'gold-standard' for the diagnosis of CTS (transverse nerve area > 12 mm² and morpho-structural alterations) and was used to assess the sensitivity and specificity of the Kamath questionnaire and the Tinel and Phanel clinical tests.

Results: 44 patients, 34 patients with RA and 10 patients with PsA were evaluated. 7 (16%) patients had a median nerve cross-sectional area > 12 mm², associated with US abnormalities of the nerve. The Kamath questionnaire showed moderate sensitivity values (71.4%) but low specificity (56.7%) for ultrasonographic diagnosis of CTS with a negative predictive value of 91.3%. Clinical tests show low sensitivity but high specificity. No statistically significant correlations were found with the main clinical variables.

Conclusions: The screening questionnaire showed moderate sensitivity but low specificity compared to the ultrasound 'gold standard'. Clinical tests may support the diagnosis of CTS in these conditions.

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炎性关节炎病程中腕部受累患者腕管综合征的评估。横断面研究。

目的：本研究的目的是评估超声检查（美国）正中神经的改变，Kamath筛查问卷和临床检查（Tinel和Phanel试验）的表现在类风湿关节炎（RA）和银屑病关节炎（PsA）患者既往或目前的桡-尺-腕关节炎症累及。患者和方法：采用横断面研究。连续招募有RA、PsA和提示CTS临床症状的患者。收集所有患者的主要临床人口学特征。在门诊访问期间对所有患者进行Kamath问卷调查。US检查被用作诊断CTS的“金标准”（横神经面积bbb12mm2和形态结构改变），并用于评估Kamath问卷和Tinel和Phanel临床试验的敏感性和特异性。结果：44例，RA 34例，PsA 10例。7例（16%）患者正中神经横截面积为12mm2，伴有神经US异常。Kamath问卷对CTS超声诊断的敏感性中等（71.4%），特异性较低（56.7%），阴性预测值为91.3%。临床试验显示敏感性低，特异性高。与主要临床变量无统计学意义相关。结论：与超声“金标准”相比，该筛查问卷敏感性中等，特异性较低。在这些情况下，临床试验可支持CTS的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Musculoskeletal Care RHEUMATOLOGY-

CiteScore

2.30

自引率

7.70%

发文量

期刊介绍： Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.