Day-to-day variability of median nerve location within the carpal tunnel

Jessica E Goetz; Daniel R Thedens; Nicole M Kunze; Ericka A Lawler; Thomas D Brown

doi:10.1016/j.clinbiomech.2010.04.009

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Day-to-day variability of median nerve location within the carpal tunnel

Journal article

Open access

Peer reviewed

Day-to-day variability of median nerve location within the carpal tunnel

Jessica E Goetz, Daniel R Thedens, Nicole M Kunze, Ericka A Lawler and Thomas D Brown

Clinical biomechanics (Bristol), Vol.25(7), pp.660-665

08/2010

DOI: 10.1016/j.clinbiomech.2010.04.009

PMCID: PMC2900433

PMID: 20605292

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Abstract

Carpal tunnel syndrome is a commonly encountered entrapment disorder resulting from mechanical insult to the median nerve. Magnetic resonance imaging (MRI)-based investigations have documented typical locations of the median nerve within the carpal tunnel; however, it is unclear whether those locations are consistent within an individual on different days. To determine the day-to-day variability of nerve location, 3.0T MRI scans were acquired from six normal volunteers over multiple sessions on three different days. Half of the scans were acquired with the wrist in neutral flexion and the fingers extended, and the other half were acquired with the wrist in 35 degrees of flexion and the fingers flexed. Prior to half of the scans (in both poses), subjects performed a preconditioning routine consisting of specified hand activities and several repetitions of wrist flexion/extension. The shape, orientation, location, and location radius of variability of the median nerve and three selected flexor tendons were determined for each subject and compared between days. Two of the six subjects had substantial variability in nerve location when the wrist was in neutral, and four of the subjects had high variability in nerve position when the wrist was flexed. Nerve variability was typically larger than tendon variability. The preconditioning routine did not decrease nerve or tendon location variability in either the neutral or the flexed wrist positions. The high mobility and potential for large variability in median nerve location within the carpal tunnel needs to be borne in mind when interpreting MR images of nerve location.

Young Adult

Magnetic Resonance Imaging

Reproducibility of Results

Median Nerve - anatomy & histology

Humans

Sensitivity and Specificity

Carpal Bones - anatomy & histology

Adult

Female

Male

Models, Anatomic

Details

Title: Subtitle: Day-to-day variability of median nerve location within the carpal tunnel
Creators: Jessica E Goetz - Department of Orthopaedics & Rehabilitation, Orthopedic Biomechanics Lab, University of Iowa, Iowa City, IA 52242, USA. jessica-goetz@uiowa.edu
Daniel R Thedens
Nicole M Kunze
Ericka A Lawler
Thomas D Brown
Resource Type: Journal article
Publication Details: Clinical biomechanics (Bristol), Vol.25(7), pp.660-665
DOI: 10.1016/j.clinbiomech.2010.04.009
PMID: 20605292
PMCID: PMC2900433
NLM abbreviation: Clin Biomech (Bristol)
ISSN: 0268-0033
eISSN: 1879-1271
Publisher: England
Grant note: AR053899 / NIAMS NIH HHS R01 AR053899 / NIAMS NIH HHS R01 AR053899-01A2 / NIAMS NIH HHS
Language: English
Date published: 08/2010
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Orthopedics and Rehabilitation
Record Identifier: 9984040284502771

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