The Role of Radiographic Indices in the Evaluation of Hand and Wrist Pathologies in Patients With Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common mononeuropathy of the upper extremity. It occurs as a result of compression of the median nerve in the carpal tunnel during its course in the wrist. Clinical symptoms are characterized by numbness and tingling in the first 3 fingers and the radial half of the 4th finger, which are compatible with the distribution of the median nerve. Electrophysiologically, it is classified as mild, moderate and severe. As the disease duration increases, atrophy and weakness may develop in the thenar muscles. The incidence is 4-5% worldwide and is more common in women between the ages of 40-60.

Pathophysiology consists of mechanical compression, increased pressure, ischemia in the median nerve and local metabolic changes.

Among the risk factors, occupations that require repeated flexion and extension of the wrist constitute environmental risk factors. Extension can increase the tunnel pressure by 10 times, while flexion can increase it by more than 8 times. Systemic risk factors for CTS are pregnancy, menopause, obesity, renal failure, hypothyroidism, oral contraceptive use, and congestive heart failure.

Diabetes, alcoholism, vitamin deficiency or toxicity, and exposure to toxins are neuropathic risk factors. Localized risk factors include mass lesions that compress the tunnel, arthritis, and radius distal end fractures.

Despite these risk factors, most cases of CTS are still classified as idiopathic.