Background A bilateral carpal tunnel syndrome (CTS) is relatively commonly connected to hypothyroidism and presents in 5 to 10% of hypothyroid patients. Ultrasound imaging is a method of choice in early recognition of dynamic changes of median nerve in subclinical stages of CTS.
Objectives Monitoring of ultrasound detectable changes of median nerve in transverse section level of carpal tunnel in patients with autoimmune hypothyroidisms.
Methods A cross sectional comparative study on patients with autoimunne hypothyroidism, where transverse section breadth of median nerve in its entrance to carpal tunnel (Cross Sectional Area, CSA) was measured. CSA values over 0,098cm2 were considered abnormal according to American Journal of Roentgenology. Values were compared with the control group of healthy subjects based on gender and BMI. Difference between groups were statistically evaluated by unpaired T-test.
Results Totally of 38 patients (mean age 64,68 yrs, 10 males/28 females, mean BMI 25,37 kg/m2, mean TSH 6,23 mU/l, fT4 15,28 pmol/l) were included in the study. The control group consists of 24 subjects (mean age 48,54 yrs, 13 males/11 females, BMI 25,00 kg/m2, mean TSH 1,54 mU/l, mean fT4 15,58 pmol/l). CSA was significantly higher in patients (mean 0.088 cm2) in comparison with controls (mean 0.071 cm2, p=0,002). In 3 hypothyroid patients pathological increase of CSA (mean 0,1 3cm2,7.8%) were presenting symptomatology.
Conclusions Ultrasound findings have documented occurrence of subclinical and clinical CTS in patients with primary hypothyroidism. If CTS occurs, the thyroidal status should be evaluated to exclude possible hypothyroidism. Ultrasound examination of CSA enables the treatment effect monitoring in soft tissue structures in carpal tunnel area and it is an appropriate method for a long term evaluation of hypothyroid patients with this complication.
Disclosure of Interest None declared
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