Turkish Neurosurgery 2015 , Vol 25 , Num 5
The Role of Wrist Magnetic Resonance Imaging in the Differential Diagnosis of the Carpal Tunnel Syndrome
Mehmet Resid ONEN1, Ali Erhan KAYALAR1, Elif Nurbegum ILBAS2, Recai GOKCAN2, Ilker GULEC3, Sait NADERI1
1Umraniye Teaching and Research Hospital, Department of Neurosurgery, Istanbul, Turkey
2Umraniye Teaching and Research Hospital, Department of Radiology, Istanbul, Turkey
3Antalya Teaching and Research Hospital, Department of Neurosurgery, Antalya, Turkey
DOI : 10.5137/1019-5149.JTN.10754-14.2 AIM: The carpal tunnel syndrome (CTS) is the commonest compressive neuropathy. Electromyography (EMG) is accepted as gold standard in diagnosis of CTS. However, pathologies and variations that are associated with a various findings may lead to failure.

MATERIAL and METHODS: Magnetic resonance Imaging (MRI) was applied to 69 wrists of 55 patients, who received a diagnosis of CTS by means of clinical and electrodiagnostic testing (EDT) during the years 2011 and 2013.

RESULTS: We detected a total of 71 additional pathologies in MRI analyses: 29 degenerative bone cysts, 28 ganglion cysts, 8 tenosynovitis, and 6 avascular necroses. While the MRI detected 44 (59.5%) additional radiological pathologies in 39 wrists diagnosed with mid-level CTS by means of EMG, the number of detected additional pathologies was 27 (36.5%) in 30 wrists diagnosed with advanced-level CTS.

CONCLUSION: Wrist MRI is an effective means to reveal associated pathologies in patients diagnosed with CTS by means of clinical testing and EDT. Additional pathologies may not only change the applicable type of surgery, but also decrease the number of postoperative failures. Wrist MRI is recommended, especially for young cases with unilateral CTS history accompanied by dubious clinical symptoms and lacking any pronounced predisposing factors. Keywords : Carpal tunnel syndrome, Magnetic resonance imaging, Compressive neuropathy, Electromyography

Corresponding author : Mehmet Resid Onen, mresid@gmail.com