Annals of Clinical Neurophysiology

  • 제23권2호
  • /
  • Pages.99-107
  • /
  • 2021
  • /
  • 2508-691X(pISSN)
  • /
  • 2508-6960(eISSN)
대한임상신경생리학회 (The Korean Society of Clinical Neurophysiology)
권호 표지
DOI QR코드

DOI QR Code

Usefulness of infrared thermography in diagnosing and evaluating severity of carpal tunnel syndrome

  • Yang, Jiwon (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Lee, Yeong-Bae (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Sung, Young-Hee (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Shin, Dong-Jin (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Kim, Yong-Jin (Department of Neurology, Gil Medical Center, Gachon University College of Medicine) ;
  • Park, Hyeon-Mi (Department of Neurology, Gil Medical Center, Gachon University College of Medicine)
  • 투고 : 2021.06.09
  • 심사 : 2021.08.10
  • 발행 : 2021.10.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

키워드

과제정보

This study was supported by the 2017 academic research funds of the Korean Society of Clinical Neurophysiology.

참고문헌

  1. Rempel D, Evanoff B, Amadio PC, de Krom M, Franklin G, Franzblau A, et al. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health 1998;88:1447-1451. https://doi.org/10.2105/AJPH.88.10.1447
  2. Witt JC, Hentz JG, Stevens JC. Carpal tunnel syndrome with normal nerve conduction studies. Muscle Nerve 2004;29:515-522. https://doi.org/10.1002/mus.20019
  3. Padua L, Padua R, Lo Monaco M, Aprile I, Tonali P. Multiperspective assessment of carpal tunnel syndrome: a multicenter study. Italian CTS Study Group. Neurology 1999;53:1654-1659. https://doi.org/10.1212/WNL.53.8.1654
  4. de Campos CC, Manzano GM, Leopoldino JF, Nobrega JA, Sanudo A, de Araujo Peres C, et al. The relationship between symptoms and electrophysiological detected compression of the median nerve at the wrist. Acta Neurol Scand 2004;110:398-402. https://doi.org/10.1111/j.1600-0404.2004.00332.x
  5. Chan L, Turner JA, Comstock BA, Levenson LM, Hollingworth W, Heagerty PJ, et al. The relationship between electrodiagnostic findings and patient symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil 2007;88:19-24. https://doi.org/10.1016/j.apmr.2006.10.013
  6. Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol 2002;113:1373-1381. https://doi.org/10.1016/S1388-2457(02)00169-4
  7. Nahm FS. Infrared thermography in pain medicine. Korean J Pain 2013;26:219-222. https://doi.org/10.3344/kjp.2013.26.3.219
  8. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993;75:1585-1592. https://doi.org/10.2106/00004623-199311000-00002
  9. Giannini F, Cioni R, Mondelli M, Padua R, Gregori B, D'Amico P, et al. A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment. Clin Neurophysiol 2002;113:71-77. https://doi.org/10.1016/S1388-2457(01)00704-0
  10. American Association of Electrodiagnostic Medicine, American Academy of Neurology, and American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 2002;25:918-922. https://doi.org/10.1002/mus.10185
  11. Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 2011;44:597-607. https://doi.org/10.1002/mus.22208
  12. Padua L, LoMonaco M, Gregori B, Valente EM, Padua R, Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand 1997;96:211-217. https://doi.org/10.1111/j.1600-0404.1997.tb00271.x
  13. Campero M, Verdugo RJ, Ochoa JL. Vasomotor innervation of the skin of the hand: a contribution to the study of human anatomy. J Anat 1993;182(Pt 3):361-368.
  14. Jones BF. A reappraisal of the use of infrared thermal image analysis in medicine. IEEE Trans Med Imaging 1998;17:1019-1027. https://doi.org/10.1109/42.746635
  15. Park GY, Chun SI, Park CI, Yim SY, Kim AY, Shin DB. Comparison of CT-myelography, electromyography and digital infrared thermographic imaging in lumbar herniated nucleus pulposus. J Korean Acad Rehab Med 1993;17:42-50.
  16. Harper CM Jr, Low PA, Fealey RD, Chelimsky TC, Proper CJ, Gillen DA. Utility of thermography in the diagnosis of lumbosacral radiculopathy. Neurology 1991;41:1010-1014. https://doi.org/10.1212/WNL.41.7.1010
  17. Meyers S, Cros D, Sherry B, Vermeire P. Liquid crystal thermography: quantitative studies of abnormalities in carpal tunnel syndrome. Neurology 1989;39:1465-1469. https://doi.org/10.1212/WNL.39.11.1465
  18. Ming Z. Upper limb musculoskeletal disorders with special reference to sympathetic nerve functions and tactile sensation [dissertation]. [Kuopio]: University of Kuopio; 2007. 93.
  19. Verghese J, Galanopoulou AS, Herskovitz S. Autonomic dysfunction in idiopathic carpal tunnel syndrome. Muscle Nerve 2000;23:1209-1213. https://doi.org/10.1002/1097-4598(200008)23:8<1209::AID-MUS8>3.0.CO;2-#
  20. Truini A, Padua L, Biasiotta A, Caliandro P, Pazzaglia C, Galeotti F, et al. Differential involvement of A-delta and A-beta fibres in neuropathic pain related to carpal tunnel syndrome. Pain 2009;145:105-109. https://doi.org/10.1016/j.pain.2009.05.023
  21. Schmid AB, Bland JD, Bhat MA, Bennett DL. The relationship of nerve fibre pathology to sensory function in entrapment neuropathy. Brain 2014;137(Pt 12):3186-3199. https://doi.org/10.1093/brain/awu288
  22. Aminoff MJ. Involvement of peripheral vasomotor fibres in carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 1979;42:649-655. https://doi.org/10.1136/jnnp.42.7.649
  23. Lane LB, Starecki M, Olson A, Kohn N. Carpal tunnel syndrome diagnosis and treatment: a survey of members of the American Society For Surgery of the Hand. J Hand Surg Am 2014;39:2181-2187.e2184. https://doi.org/10.1016/j.jhsa.2014.07.019
  24. Ming Z, Zaproudina N, Siivola J, Nousiainen U, Pietikainen S. Sympathetic pathology evidenced by hand thermal anomalies in carpal tunnel syndrome. Pathophysiology 2005;12:137-141. https://doi.org/10.1016/j.pathophys.2005.05.002
  25. Mondelli M, Vecchiarelli B, Reale F, Marsili T, Giannini F. Sympathetic skin response before and after surgical release of carpal tunnel syndrome. Muscle Nerve 2001;24:130-133. https://doi.org/10.1002/1097-4598(200101)24:1<130::AID-MUS20>3.0.CO;2-H
  26. Goadsby PJ, Burke D. Deficits in the function of small and large afferent fibers in confirmed cases of carpal tunnel syndrome. Muscle Nerve 1994;17:614-622. https://doi.org/10.1002/mus.880170608
  27. Zyluk A, Kosovets L. An assessment of the sympathetic function within the hand in patients with carpal tunnel syndrome. J Hand Surg Eur Vol 2010;35:402-408. https://doi.org/10.1177/1753193409361292
  28. Clarke C, Christensen C, Curran MWT, Chan KM. Assessment of small sensory fiber function across the spectrum of severity in carpal tunnel syndrome patients. Muscle Nerve 2017;56:814-816. https://doi.org/10.1002/mus.25592
  29. Herrick RT, Herrick SK. Thermography in the detection of carpal tunnel syndrome and other compressive neuropathies. J Hand Surg Am 1987;12(5 Pt 2):943-949. https://doi.org/10.1016/S0363-5023(87)80262-9
  30. So YT, Olney RK, Aminoff MJ. Evaluation of thermography in the diagnosis of selected entrapment neuropathies. Neurology 1989;39:1-5. https://doi.org/10.1212/WNL.39.1.1
  31. Mondelli M, Reale F, Sicurelli F, Padua L. Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome. J Hand Surg Br 2000;25:128-134.