Shawn C. Roll, Kevin D. Evans, Xiaobai Li, Carolyn M. Sommerich, Jane Case-Smith; Importance of Tissue Morphology Relative to Patient Reports of Symptoms and Functional Limitations Resulting From Median Nerve Pathology. Am J Occup Ther 2013;67(1):64–72. https://doi.org/10.5014/ajot.2013.005785
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Significant data exist for the personal, environmental, and occupational risk factors for carpal tunnel syndrome. Few data, however, explain the interrelationship of tissue morphology to these factors among patients with clinical presentation of median nerve pathology. Therefore, our primary objective was to examine the relationship of various risk factors that may be predictive of subjective reports of symptoms or functional deficits accounting for median nerve morphology. Using diagnostic ultrasonography, we observed real-time median nerve morphology among 88 participants with varying reports of symptoms or functional limitations resulting from median nerve pathology. Body mass index, educational level, and nerve morphology were the primary predictive factors. Monitoring median nerve morphology with ultrasonography may provide valuable information for clinicians treating patients with symptoms of median nerve pathology. Sonographic measurements may be a useful clinical tool for improving treatment planning and provision, documenting patient status, or measuring clinical outcomes of prevention and rehabilitation interventions.
Clinicians providing interventions for carpal tunnel syndrome and other work-related musculoskeletal disorders should consider how to best target these interventions to the underlying physiological mechanisms, an approach that may ultimately affect symptoms and functional status.
Real-time visualization of pathophysiology and tissue morphology may improve the evaluation and interpretation of personal, environmental, or occupational risk factors for musculoskeletal disorders, leading to improved individualized treatment planning.
Sonographic imaging is highly portable and can provide real-time visualization of tissue morphology. It may be a valuable clinical and research tool to enhance decision making and monitor changes in tissue morphology subsequent to therapeutic interventions.
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