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Palmar bowing of the flexor retinaculum on wrist MRI correlates with subjective reports of pain in carpal tunnel syndrome

  1. Masaya Tsujii MD, PhD1,*,
  2. Hithoshi Hirata MD, PhD2,
  3. Akimasa Morita MD3,
  4. Atsumasa Uchida MD, PhD1

Article first published online: 22 APR 2009

DOI: 10.1002/jmri.21459

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 29, Issue 5, pages 1102–1105, May 2009

Additional Information

How to Cite

Tsujii, M., Hirata, H., Morita, A. and Uchida, A. (2009), Palmar bowing of the flexor retinaculum on wrist MRI correlates with subjective reports of pain in carpal tunnel syndrome. J. Magn. Reson. Imaging, 29: 1102–1105. doi: 10.1002/jmri.21459

Author Information

  1. 1

    Department of Orthopaedic Surgery, Mie University Faculty of Medicine, Mie, Japan

  2. 2

    Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

  3. 3

    Department of Orthopaedic Surgery, Suzuka Kaisei Hospital, Japan

*2-174 Edobashi, Tsu City, Mie 514-8507, Japan

Publication History

  1. Issue published online: 22 APR 2009
  2. Article first published online: 22 APR 2009
  3. Manuscript Accepted: 2 MAY 2008
  4. Manuscript Received: 17 JAN 2008

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Keywords:

  • carpal tunnel syndrome;
  • magnetic resonance imaging;
  • palmar flexor bowing of flexor retinaculum;
  • pain severity

Abstract

Purpose

To investigate the utility of palmar bowing of the flexor retinaculum (PBFR) on magnetic resonance imaging (MRI) as an adjunct to presurgical evaluation of carpal tunnel syndrome (CTS).

Materials and Methods

The CTS group comprised 48 women with CTS diagnosed from clinical history, physical examination, and electrophysiological findings. Another 21 healthy women with no symptoms of CTS served as controls. The CTS group was divided into four subgroups based on symptom duration. CTS patients were preoperatively assessed for symptom severity using a Likert scale. In both groups, palmar bowing of the flexor retinaculum (PBFR) was measured on MRI. Furthermore, relationships with disease duration, subjective symptom severity, and electrophysiological findings were assessed in the CTS group.

Results

Although PBFR increased significantly in all CTS groups when compared to the control group, PBFR in patients who complained of severe pain tended to exceed that in patients with mild to moderate pain. Statistical analysis showed a positive correlation between PBFR and pain severity. In contrast, PBFR did not reflect median nerve function.

Conclusion

PBFR as seen on MRI seems to correlate significantly with patients' subjective reports of pain severity. J. Magn. Reson. Imaging 2009;29:1102–1105. © 2009 Wiley-Liss, Inc.

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