engleski

Impact of body mass index and wrist circumference on carpal tunnel syndrome.

Introduction/Objectives: Carpal tunnel syndrome is the most common entrapment neuropathy caused by compression of median nerve (MN) in the carpal tunnel. In majority of cases it is considered to be idiopathic. Clinical presentation usually includes paresthesia and pain in the affected hand (usually prominent during the night), hypesthesia in the median nerve distribution and weakness of muscles innervated by the median nerve. Various risk factors have been previously proposed and evaluated. We present here our results on the relation of anthropometric measures – body mass index (BMI) and wrist circumference (WC) - with CTS and its characteristics. Participants, Materials/Methods: A total of 88 CTS patients and 78 healthy controls were included in our study and the same number of hands were evaluated. Historical-objective-distribution (HiObDb) scale was used for clinical symptom quantification. Wrist circumference was measured at the distal wrist crease. Additionally, provocative tests (Hoffmann-Tinel and Phalen) were assessed. EMNG was performed and, based on findings severity, patients were classified into 6 categories (0-5). Ultrasound of the carpal tunnel was used to obtain MN measures on 4 anatomical levels – forearm, carpal tunnel inlet, mid-tunnel and tunnel outlet. Results: Significant difference was found in BMI (p < 0.001) between the CTS and control group with mean values of 29.4kg/m2 and 26.1kg/m2, respectively. Higher mean BMI was found in Tinel positive patients as well as with HiObDb stage (both p<0.001), but mean was not significantly different for Phalen's sign or presence of pain. Correlation of BMI and EMNG grade was also found. All ultrasound parameters except inlet-outlet ratio and mid-tunnel cross sectional area significantly correlated with BMI. There was also significant difference in wrist circumference (p < 0.001) between both groups with mean values of 17.8cm and 16.8cm in CTS and control groups, respectively. Finally, ROC curve analysis for BMI and WC showed higher sensitivity of WC (58.7% vs 46%) and higher specificity of BMI (88.5% vs 68%) in confirmation of CTS. Conclusions: Anthropometric measures – BMI and wrist circumference - may play a role in development of carpal

carpal tunnel syndrome ; body mass index ; wrist circumference

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