Evaluation of wrist radiographic indices in people with idiopathic carpal tunnel syndrome: a prospective cross-sectional study.

BACKGROUND

Idiopathic carpal tunnel syndrome (ICTS) is a common condition characterized by compression of the median nerve at the wrist, leading to symptoms like pain, numbness, and weakness.

OBJECTIVE

This study aims to compare wrist radiographic characteristics of participants with ICTS to those without ICTS and to examine their relationship with carpal tunnel syndrome (CTS) severity and symptomatology.

METHODS

This is a prospective case-control study. The study included 136 participants with ICTS and 221 affected hands, along with a control group of 139 participants without ICTS with 240 hands. Within the case group, the electrophysiological severity and symptom severity of CTS were compared with radiographic findings. Ulnar variance (UV), radial inclination (RI), volar tilt (VT), radiolunate angle (RLA), radioscaphoid angle (RSA), scapholunate angle (SLA), wrist anteroposterior diameter (APD), wrist transverse diameter (TD), and carpal height ratio (CHR) were measured on wrist radiographs of both the case and control groups, and the results were statistically compared.

RESULTS

Body mass index (BMI) was significantly higher in the ICTS group (32.01 vs 28.4; P < 0.01). In the ICTS group, RI was significantly lower (P < 0.05), whereas RLA, RSA, and SLA were significantly higher than in the control group (P < 0.01 for all). Both positive and negative UV values were significantly elevated in ICTS cases (P < 0.001). Within the CTS group, RLA showed a positive association with electrophysiological severity, whereas SLA showed a negative association (P < 0.05 for both). RSA was the only radiographic parameter significantly associated with symptom severity (P < 0.01).

CONCLUSION

Decreased RI, increased frequency of both positive and negative UV, and increased SLA, RLA, and RSA were strongly associated with scapholunate dissociation (SLD) in participants with ICTS. Decreased RI and increased positive/negative UV are anatomical risk factors for SLD in people with ICTS. SLD may play a role in the pathogenesis of ICTS.

DATA REGISTRATION REFERENCE: ClinicalTrials.gov Identifier: NCT06841809.