J Rheum Dis.  2023 Jan;30(1):36-44. 10.4078/jrd.22.0028.

Carpal Tunnel Syndrome in Patients with Psoriatic Arthritis: Ultrasonography and Magnetic Resonance Imaging Findings

• Tezcan EA
• Levendoglu F
• Durmaz MS
• Kara H
• i Batur EB
• Gezer IA
• Korez MK

• KMID: 2537493
• DOI: http://doi.org/10.4078/jrd.22.0028

Abstract

Objective
The aim of the present study is to assess carpal tunnel syndrome's (CTS’s) ultrasonography (US) and magnetic resonance imaging (MRI) findings in patients with psoriatic arthritis (PsA) and compare them with healthy controls.
Methods
Thirty-nine PsA and twenty-eight healthy volunteers were examined in this study. Demographic and clinical features were recorded. CTS-6, a diagnostic algorithm, was used to estimate the probability of CTS. Electrodiagnostic study (EDS) was applied to all wrists included in the report, where the diagnosis of CTS was made by EDS. The cross-sectional area (CSA) of the median nerve was measured at pisiform bone level by US and MRI.
Results
Regarding to the demographic characteristics, no statistically significant difference was found between the groups. Twelve of 39 (30.76%) PsA patients had CTS, whereas CTS was not detected in the control group (p=0.001). US and MRI showed increased median nerve CSA in PsA patients compared to healthy controls (p=0.005, p<0.001; respectively). Also, US and MRI showed increased median nerve CSA in CTS patients compared to others (p=0.002, p<0.001; respectively). The Pearson correlation coefficient between MRI and US measurements of the CSA was 0.85 (p<0.001).
Conclusion
CTS frequency in PsA patients is found higher than healthy controls. The relationship between CTS diagnosed by EDS and CSA measured by both US and MRI was observed in PsA patients.

Keyword

Psoriatic arthritis; Carpal tunnel syndrome; Ultrasonography; Magnetic resonance imaging

Figure

• 

  Fig. 1 An example of the measurement of the cross-sectional area of median nerve on ultrasonography.

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  Fig. 2 An example of the measurement of the cross-sectional area of median nerve on axial T2-weighted magnetic resonance imaging.

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  Fig. 3 Mean median nerve cross-sectional areas with error bars (standard deviation) for ultrasonography (US) (A) and for magnetic resonance imaging (MRI) (B). CSA: cross-sectional areas, PsA: psoriatic arthritis, EDS: electrodiagnostic study, CTS: carpal tunnel syndrome.

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  Fig. 4 US versus MRI CSA. Trend-line demonstrates correlation of 0.85. US: ultrasonography, MRI: magnetic resonance imaging, CSA: cross-sectional area.

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