ROLE OF ELASTOGRAPHY IN ASSESSING MEDIAN NERVE CHANGES IN RHEUMATOID ARTHRITIS PATIENTS WITHOUT SYMPTOMS OF CARPAL TUNNEL SYNDROME

Abstract

Introduction: Rheumatoid arthritis (RA) is autoimmune disorder with increased prevalence in the female population especially in older age. The association of carpal tunnel syndrome (CTS) in RA is well-known and the median nerve involvement is extensively studied in RA and CTS. However, the elastography measurements in RA without CTS are least studied. Hence the present assessed the role of sonoelastography in detecting the median nerve changes before development to CTS in subjects with rheumatoid arthritis. Material and methods: This were a prospective study involving subjects with RA without any symptoms of CTS as cases and healthy individuals as controls. Sonoelastography was performed in all study participants and the cross-sectional area and strain ratio were evaluated by sonoelastography in all subjects. Chi-square used to test significance for qualitative data and an independent t-test was used as a test of significance for quantitative data. p value < 0.001 was considered statistically significant. Results: This study involved 112 subjects with equal subjects (56 each) in cases and control group. The mean age in the cases group was 48.5 ± 13.31years and in the control group was 48.02 ± 13.41 years. There was significant difference among the cases and controls in right and left side cross-sectional area (Cm2) (P< 0.001). There was statistically significant difference between controls and cases in right and left side strain ratio (P< 0.001). Conclusion: The use of sonoelastography in evaluating the median nerve changes in RA subjects without CTS was useful as changes in the CSA and strain ratio was significant in xx cases compared to controls. Early diagnosis of median nerve changes can be made before developing to carpal tunnel syndrome in Rheumatoid arthritis patients using sonoelastography.