• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.114-118
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• 2002

Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

• Journal of Pharmacopuncture
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• v.13 no.4
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• pp.75-89
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• 2010

Objectives : The purpose of this study is to compare the effects of Sweet Bee Venom Pharmacopuncture and Scolopendrid Pharmacopuncture on Carpal Tunnel Syndrome. Methods : From February to September 2010, the number of patients with Carpal Tunnel Syndrome who volunteered for this clinical study was 16 and 7 out of 16 patients complained both hands. Total 23 cases of hands were randomly divided by 2 groups. We injected Sweet Bee Venom Pharmacopuncture on PC7(Daereung) twice a week for 4weeks for experimental group(n=11), and Scolopendrid Pharmacopuncture with the same methods for control group(n=12). One case was dropped out due to itchiness of allergic response in the experimental group. Improvement of the symptoms was evaluated by Visual Analogue Scale, Pain Rating Scale, Tinel's sign, Phalen's sign and Nerve Conduction Velocity. Nerve Conduction Velocity was checked at baseline and the end of the trial and others were checked at baseline, after 2 and 4 weeks. Results : Both groups showed significant improvement in Visual Analogue Scale, Pain Rating Scale, but no significant difference between two groups. Only the control group showed significant reduction of the 'poitive response' in the Tinel's sign and Phalen's sign. However, no groups improved in Nerve Conduction Velocity. Conclusions : These results showed that Sweet Bee Venom Pharmacopuncture and Scolopendrid Pharmacopuncture could decrease the symptoms of Carpal Tunnel Syndrome. Further studies will be required to examine more cases for the long period and use more various concentration and amount pharmacopuncture for the effect on Carpal Tunnel Syndrome.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.507-519
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• 1996

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.87-93
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• 2007

Objectives : This study was to assess the effectiveness of Oriental medical treatment on carpal tunnel syndrome, comparing its outcome with that of Western medical treatment. Methods : After being diagnosed with carpal tunnel syndrome by electromyography, subjects were enrolled in Kyung Hee Medical Center from March 2006 to January 2007. We prescribed Kejibokryung-hwan to the Oriental medical therapy group (OM group) and NSAIDS to the Western medical therapy group (WM group). Effectiveness was assessed by degree of pain using visual analog scale (VAS) before and after 3 weeks' treatment. Adverse effects were also monitored. Results : There were 21 patients in the OM group and 19 in the WM group. No statistical significant difference was detected at the baseline assessment. After 3 weeks of medication, pain was reduced about 26% in the OM group and 46% in the WM group. These findings might be explained by that more than half of the WM group received local steroid injection, which has been known to have more rapid analgesic effect that oral medication. Although pain reduction rate was higher in the WM group than in the OM group, we suggest that Oriental medical treatment is still effective, faking into consideration the fact that completely recovered cases were found only in the OM group. No adverse effect was found in either of the groups. Conclusion : This work could help us to understand the effectiveness of Oriental medical treatment on carpal tunnel syndrome.