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Classifying median nerves in carpal tunnel syndrome: Ultrasound image analysis

Obuchowicz Rafał, Kruszyńska Julia, Strzelecki Michał

Biocybernetics and Biomedical Engineering

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2021

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Vol. 41, no. 2

335--351

EN

Rationale and objectives: Carpal tunnel syndrome (CTS) refers to a common median nerve pathology, which is related to an increased pressure in the fibrous/bone canal of the wrist. Ultrasound gained popularity recently as a useful tool for the accurate and repetitive diagnosis of carpal tunnel syndrome. The present study aimed to develop an objective, repetitive technique for assessing median nerves based on carpal tunnel ultrasound texture analysis. Material and methods: Sixty ultrasound images, including 30 images of swollen ‘‘symptomatic” median nerves and 30 normal ‘‘asymptomatic” median nerves, were used in this study. Narrow age group of patients were selected. They were recruited after positive nerve conduction study and with present clinical symptoms reviled on basis of interview and written questionnaire. Meticulous nerve area and echogenicity assessment were conducted in line with existing recommendations. Results: Using the feature-selection tool MaZda, an exhaustive search of the data space was conducted, and four texture features were found for which the classification was the most accurate. Images were classified using a support vector machine with a five-fold cross-verification in MATLAB. Evoked outcomes showed a 79% correct classification rate. Conclusion: Computer analysis of the image echogenicity of the median nerve presented confidence levels comparable to trusted evaluation techniques. Further, it is a promising tool for assessing the nerve’s status in CTS as approach of the CTS assessment free from subjectivity of examiner. The developed method enables nerve classification based on echogenicity that reflects the nerve composition changes not only subjective nerve area assessment.

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Ocena przydatności krzywej i/t do diagnostyki zespołu kanału nadgarstka

Georgiew F., Maciejczak A., Kania A., Gancarz E.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2013

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Vol. 19, nr 1

40--48

PL

Wyznaczanie krzywej i/t jest badaniem elektrodiagnostycznym pozwalającym ocenić stopień uszkodzenia nerwu obwodowego. Do badania stosuje się prąd stały o impulsach prostokątnych i trójkątnych. Czas trwania impulsów wynosi zazwyczaj 1000 ms. W pracy zbadano 88 chorych (70 kobiet i 18 mężczyzn) leczonych z powodu zespołu kanału nadgarstka (ZKN) w poradni przyszpitalnej i na oddziale neurochirurgicznym. U 19 chorych objawy miały charakter obustronny, tak więc łączna ilość wszystkich zbadanych przypadków wyniosła 107. Wiek chorych wyniósł średnio 54,4 lat. Ciężkość ZKN oceniono przy pomocy badania elektrodiagnostycznego. Grupa kontrolna obejmowała 31 osób: 15 kobiet i 16 mężczyzn, średnia wieku 23 lata, u których na podstawie badania klinicznego nie stwierdzono zaburzeń w funkcji nerwu pośrodkowego (objawów charakterystycznych dla ZKN). Krzywa i/t nie jest wystarczająco czułym i specyficznym badaniem, które może być wykorzystywane w diagnostyce pacjentów z ZKN. Nie występują istotne statystycznie różnice w kształcie krzywej w poszczególnych stopniach ciężkości ZKN oraz w grupie pacjentów zdrowych. Natomiast jakościowa ocena wartości progowej akomodacji oraz współczynnika akomodacji może posłużyć do różnicowania pacjentów z ciężkim nasileniem zespołu.

EN

Determination of the i/t curve is an electrodiagnostics method enabling diagnosis of the lesion of peripheral nerves. The method utilizes triangularly and rectangularly shaped direct current impulses, usually 1000 ms. In this study 88 patients were tested (70 women and 18 men) who were being treated due to carpal tunnel syndrome CTS at a hospital clinic and a neurosurgical ward. In 19 patients the symptoms were bilateral, hence the combined number of all tested cases was 107. The age of the patients was from 25 to 81, with the average equal 55. The severity of CTS was evaluated by means of electrodiagnostic testing. The control group included 31 persons: 15 females and 16 males (average 23 years), with no disorders of the function of the median nerve. It was stated that the i/t curve is not sufficiently sensitive and specific examination for the diagnosis of carpal tunnel syndrome. However, the qualitative assessment: threshold value of accommodation and accommodation coefficient can be used to differentiate the patients with severe carpal tunnel syndrome.

3

Neck–Upper Extremity Musculoskeletal Disorders Among Workers in the Telecommunications Company at Mansoura City

El-Bestar S. F., El-Mitwalli A. A. M., Khashaba E. O.

International Journal of Occupational Safety and Ergonomics

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2011

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Vol. 17, No. 2

195--205

EN

Objectives. This study was to determine the prevalence and work-related risk factors of neck–upper extremity musculoskeletal disorders (MSDs) among video display terminal (VDT) users. Methods. A comparative cross-sectional study was conducted; there were 60 VDT users and 35 controls. The participants filled in a structured questionnaire, had electrophysiological tests and an X-ray of the neck. Results. The prevalence of MSDs was higher (28.3%) among VDTs users compared to controls (14.3%) with no statistically significant difference. The prevalence of cervical disorders with or without radiculopathy (18.3%) was the most common disorder followed by carpal tunnel syndrome (6.6%). The mean (SD) age of MSD cases (51 ± 7.2 years) was statistically significantly higher than of the controls (42.8 ± 9). Physical exposure to prolonged static posture (OR: 6.9; 95% CI: 0.83–57.9), awkward posture (OR: 5.5; 95% CI: 0.6–46.4) and repetitive movements (OR: 5.5; 95% CI: 0.65–46.4) increased risk of MSDs with a statistically significant difference for static posture only (p < .05). VDT users experienced more job dissatisfaction, work-overload and limited social support from supervisors and colleagues. Conclusion. VDT use did not increase the risk of neck–upper extremity MSDs. The risk increased with older age and static posture.

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Carpal Tunnel Syndrome in Occupational Medicine Practice

Bugajska J., Jędryka-Góral A., Sudoł-Szopińska I., Tomczykiewicz K.

International Journal of Occupational Safety and Ergonomics

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2007

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Vol. 13, No. 1

29--38

EN

Work-related overload syndromes are chiefly associated with the upper limbs, where carpal tunnel syndrome (CTS) plays a leading role. This article analyses methods of diagnosing CTS, with special emphasis on those that can be used by physicians in early diagnosis of CTS in workers doing monotonous work. It also discusses occupational (e.g., assembly work, typing, playing instruments, packaging and work associated with the use of a hammer or pruning scissors) and extra-occupational factors (e.g., post-traumatic deformation of bone elements of the carpal tunnel, degenerative and inflammatory changes in tendon sheaths, connective tissue hypertrophy or formation of crystal deposits) leading to CTS; diagnostic methods (subjective symptoms, physical examination, manual provocative tests, vibration perception threshold, electrophysiological examination and imaging methods); and therapeutic and preventive management tools accessible in occupational medicine practice.

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A New Approach to the Mouse Arm Syndrome

Ullman J., Kangas N., Ullman P., Wartenberg F., Ericson M.

International Journal of Occupational Safety and Ergonomics

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2003

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Vol. 9, No. 4

463--477

EN

OBJECTIVES: The study validates a new computer mouse concept. The tested device is a small mouse with a pivoting pen-shaped handle. The hypothesis behind the design is the assumptions that the pen grip requires less static tension than the normal mouse grip and that fine-motor, high precision tasks normally are done with finger movements with forearm at rest. METHODS: Four muscles were monitored with electromyography (EMG) during work with a new mouse and with a traditional mouse. RESULTS: EMG activity was significant lower, in M. pronator teres - 46%, M. extensor digitorum - 46%, M. trapezius - 69%, and M. levator scapulae - 82%, during work with the new mouse as compared to the traditional mouse. CONCLUSION: Altering the design of the computer mouse can significantly reduce muscular tension.