Ultrasonographic Study of Median Nerve according to Changed Wrist Position.

, Kim, Gyeong Sin; , Koh, Seong Eun; , Kim, Jong Moon; , Chung, Jin Sang; , Lee, Chang Hee

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2003;27(2):228-231.

Kim, Gyeong Sin , Koh, Seong Eun , Kim, Jong Moon , Chung, Jin Sang , Lee, Chang Hee

¹Department of Rehabilitation Radiology, College of Medicine, Konkuk University, Korea. jmoonkim@hitel.net
²Department of Rehabilitation Medicine, College of Medicine, Konkuk University, Korea.

진단 초음파를 이용한 손목위치 변화에 따른 정중신경의 구조적 변화 관찰

김경신, 고성은, 김종문, 정진상, 이창희¹

건국대학교 의과대학 재활의학교실, ¹방사선과학교실

Abstract

Objective
To compare the diagnostic value between Phalen's test and reverse Phalen's test using a morphological change of the median nerve and the carpal tunnel seen by high-resolution ultrasonography and to research on an ultrasonography as an available tool for the screening and follow up aid-test of the carpal tunnel syndrome (CTS).

Method
A cross-sectional area and a flattening ratio of the median nerve, and a cross-sectional area of the carpal tunnel were measured in neutral, maximally flexed (Phalen's test), and maximally extended (reverse Phalen's test) positions in 59 wrists of 30 normal subjects.

Results
The cross-sectional area of median nerve was significantly decreased in maximal flexion (p＜0.01), and in maximal extension (p＜0.01). The mean flattening ratio of median nerve was revealed significant change in maximal flexion (p＜0.01), and in maximal extension (p＜0.01). The mean cross-sectional area of the carpal tunnel was significantly decreased in maximal flexion (p＜0.01), and in maximal extension (p＜0.01), with comparing to neutral position, respectively.

Conclusion
Phalen's test reveals higher degree of irritation to median nerve. The high-resolution ultrasonography is suggested as an available tool for the screening and follow up aid-test for the CTS. (J Korean Acad Rehab Med 2003; 27: 228-231)

Key Words: Phalen's test, Reverse Phalen's test, Carpal tunnel syndrome, Ultrasonography