Carpal tunnel syndrome

Patient Positioning

Patient seated in front of the examiner, hand palm up resting on a examination table.

Probe Positioning

Place the transducer on a transverse plane over the proximal carpal tunnel – bony landmarks are: the pisiform ulnar and the scaphoid tubercle radial.

Note: scanning of the median nerve (transverse planes) from proximal to distal in a patient with carpal tunnel syndrome

Note: dynamic scanning of the median nerve during active flexion and extension of the fingers in a patient with carpal tunnel syndrome

Note: perineural infiltration of the median nerve in a patient with carpal tunnel syndrome

Note: median nerve with changes of its diameter and hypoechogenic swelling, hypomobility during dynamic testing.

Note: change of diameter of the median nerve (longitudinal view) in a patient with carpal tunnel syndrome with swelling of the nerve proximal to the entrapment.

mn: median nerve
ft: flexor tendons

Note: worker with mild carpal tunnel syndrome an muscle intrusion into the carpal tunnel especially neutral position (extension of the fingers – upper image), no muscle intrusion during flexion of the fingers (lower image)

Note: patient with secondary carpal tunnel syndrome due to massive exsudative tenosynovitis of the flexor tendons with sampling of CPPD crystals.