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High‐resolution ultrasound analysis of subsynovial connective tissue in human cadaver carpal tunnel
Author(s) -
Ettema Anke M.,
Belohlavek Marek,
Zhao Chunfeng,
Oh Sang Ho,
Amadio Peter C.,
An KaiNan
Publication year - 2006
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20252
Subject(s) - carpal tunnel syndrome , cadaver , medicine , carpal tunnel , tendon , anatomy , ultrasound , connective tissue , radiology , pathology
The carpal tunnel contains the median nerve, nine flexor tendons, two synovial bursae, and peritendinous subsynovial connective tissue (SSCT). Fibrosis of the SSCT is the most consistent pathological finding in patients with carpal tunnel syndrome. We investigated the anatomy and gliding characteristics of the flexor digitorum superficialis tendon and its adjacent SSCT with high‐resolution ultrasound (15 MHz). Our hypotheses were that tendon and SSCT are distinguishable by ultrasound and that their velocities during tendon excursion are different. Qualitative ultrasound analysis of a flexor tendon and its SSCT was performed on five cadaver wrists and correlated to respective findings after anatomical study of the same cadavers. Quantitative Doppler velocity analysis of eight cadaver wrists was done to assess the sliding movement of the tendon and its SSCT within the carpal tunnel. No significant difference was found between the thickness of SSCT measured by ultrasound and that measured directly after dissection. The SSCT moved slower than its flexor tendon. The SSCT velocities were statistically different from the tendon velocities ( t ‐test, p > 0.001). High‐resolution ultrasound is a very precise method to display the anatomy of the tendon and SSCT within the carpal tunnel, and their different velocities can be detected with Doppler. Noninvasive assessment of the thickness and velocity of the tenosynovium in carpal tunnel syndrome by high‐resolution sonography might be a new diagnostic tool for disorders affecting the SSCT, especially carpal tunnel syndrome. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:2011–2020, 2006