Preview

Department of Traumatology and Orthopaedics

Advanced search

Differential diagnosis of the most common сompressive neuropathy of the upper limb

https://doi.org/10.17238/2226-2016-2023-3-74-82

Abstract

Background. Currently there are many articles that describe the most specific symptoms, diagnostic tests and studies aimed at verifying the diagnosis of tunnel neuropathies. However, the problem of a low level of awareness among doctors who do not have enough experience in such pathologies treatment still exists. Often incorrect diagnoses are made, which not only do not alleviate the patient clinical symptoms but, on the contrary, aggravate it.

Review purpose. To determine and identify the main diagnostic criteria that allow to differentiate the most common tunnel syndromes of the upper limb.

Results. After analyzing the most common forms of upper limb tunnel syndromes, we have formed a table of «differential diagnosis» of the main symptoms and diagnostic criteria of the described conditions.

Conclusion. Developed table of «differential diagnosis» of the most common upper limb tunnel syndromes makes it possible to simplify the process of their verification, which can significantly reduce the rate of making incorrect diagnoses.

About the Authors

M. A. Zhogina
Vreden National Medical Research Center of Traumatology and Orthopedics
Russian Federation

Zhogina Margarita A. – traumatologist-orthopedist of traumatology department №8

195427, St. Petersburg



E. V. Veber
Vreden National Medical Research Center of Traumatology and Orthopedics
Russian Federation

Veber Evgeniy V. – MD, PhD, head of traumatology department №8

195427, St. Petersburg



References

1. Spinner, R. J., Amadio, P. C. Compressive neuropathies of the upper extremity. Clinics in Plastic Surgery. 2003; 30(2), 155-173. doi: 10.1016/s0094-1298(02)00103-7;

2. Adilova A.S., Pain phenomena in hand as the debut of tunnel syndromes. Modern Science. 2021; № 3-1. – С. 217-222.EDN: THYVUV;

3. Khodorkovsky M.A., Skorynin O.S., Starchenkov K.N. and others. Carpal tunnel syndrome: Are all problems resolved? Annals of Plastic, Reconstructive and Aesthetic Surgery. 2018; № 1. - S. 106-107. EDN: XMHUJF;

4. McCabe S.J. Diagnosis of carpal tunnel syndrome. J Hand Surg Am. 2010 Apr;35(4):646-8. doi: 10.1016/j.jhsa.2009.12.034;

5. Pfandl S, Wetzel R, Hackspacher J, Puhl W. Supinator tunnel syndrome - a differential diagnosis of so-called tennis elbow. Sportverletz Sportschaden. 1992 Jun; 6(2):71-6. German. doi: 10.1055/s-2007-993530;

6. Spinner R.J., Bachman J.W., Amadio P.C. The many faces of carpal tunnel syndrome. Mayo Clin Proc. 1989 Jul;64(7):829-36. doi: 10.1016/s0025-6196(12)61756-x;

7. Mononeuropathies Guidelines, 2022;

8. Papanicolaou G.D., McCabe S.J., Firrell J. The prevalence and characteristics of nerve compression symptoms in the general population. J Hand Surg Am. 2001 May;26(3):460-6. doi: 10.1053/jhsu.2001.24972;

9. Savitskaya N. G., Pavlov E. V., Shcherbakova N. I., Yankevich D. S. Electroneuromiography in the diagnosis of carpal tunnel syndrome. Annals of Clinical and Experimental Neurology. 2011. №2;

10. Atroshi I., Gummesson C., Johnsson R. et al. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999; Vol. 282. P.153–158. doi: 10.1001/jama.282.2.153;

11. De Krom M.C., Knipschild P.G., Kester A.D. et al. Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol. 1992;Vol. 45. P.373–376. doi: 10.1016/0895-4356(92)90038-o;

12. Assmus, Hans; Antoniadis, Gregor; Bischoff, Christian. Carpal and cubital tunnel and other, rarer nerve compression syndromes. Deutsches Ärzteblatt international. 2015; 112(1-2), 14–25; doi:10.3238/arz-tebl.2015.0014;

13. Ntani G., Palmer K.T., Linaker C. et al. Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome. BMC. Musculoskelet Disord. 2013. Vol. 14. P.242. doi: 10.1186/1471-2474-14-242;

14. Mizia E., Tomaszewski K., Depukat P. et al. Median nerve (anatomical variations) and carpal tunel syndrome – revisited. Folia Med Cracov. 2013; Vol. 53(4). P.37–46. PMID: 25556510;

15. Aroori S., Spence R.A. Carpal tunnel syndrome. Ulster Med J. 2008; Vol. 77(1). P. 6–17. PMCID: PMC2397020;

16. SukhininT.Yu., NazarianG.A. Clinicheskie testy v hirurgii kisti. Clinical tests in hand surgery. Voprosy rekonstruktivnoy iplasticheskoy hirurgii. 2017;20(4 (63)):66–79. doi: 10.17223/1814147/63/07;

17. Ochi K, Horiuchi Y, Tazaki K, Takayama S, Matsumura T: Fascicular constrictions in patients with spontaneous palsy of the anterior interosseous nerve and the posterior interosseous nerve. J Plast Surg Hand Surg 2012; 46: 19–24. doi:10.3109/2000656X.2011.634558;

18. Pham M. MR-Neurographie zur Läsionslokalisation im peripheren Nervensystem. Warum, wann und wie? Nervenarzt. 2014; 85: 221–37. doi:10.1007/s00115-013-3951-0;

19. Nakashian M.N., Ireland D., Kane P.M. Cubital Tunnel Syndrome: Current Concepts.Current Reviews in Musculoskeletal Medicine. 2020; 13, 520–524. doi: 10.1007/s12178-020-09650-y;

20. Burahee A.S., Sanders A.D., Shirley C., Power D.M. Cubital tunnel syndrome. EFORT Open Rev. 2021 Sep 14;6(9):743-750. doi: 10.1302/2058-5241.6.200129;

21. Golubev VL, Merkulova DM, Orlova OR, Danilov AB. Tunnel syndromes of the hand. BC. 2009;7.;

22. Aleksenko D., Varacallo M. Guyon Canal Syndrome. StatPearls Internet. Treasure Island (FL): StatPearls. 2022 Jan; PMID: 28613717;

23. Coraci D., Loreti C,. Piccinini G,. Doneddu P.E., Biscotti S., Padua L.. Ulnar neuropathy at wrist: entrapment at a very «congested» site. Neurol Sci. 2018 Aug; 39(8):1325-1331. doi: 10.1007/s10072-018-3446-7;

24. Lee J.H., Lee J.K., Park J.S., Kim D.H., Baek J.H., Yoon B.N., Kim S., Ha C., Cho W.M., Han S.H. Characteristics of surgically treated Guyon canal syndrome: A multicenter retrospective study. J Plast Reconstr Aesthet Surg. 2022 Sep; 75(9):3269-3278. doi: 10.1016/j.bjps.2022.04.049;

25. Wheeler R, DeCastro A. Posterior Interosseous Nerve Syndrome. StatPearls Internet. Treasure Island (FL): StatPearls. 2022 Jan. PMID: 31082090;

26. Spinner M. The arcade of Frohse and its relationship to posterior interosseous nerve paralysis. The Journal of Bone and Joint Surgery. British Volume. 1968; 50(4);809-812. PMID: 4303278;

27. Druzhinin DS, Novikov ML, Fedorov AV, et al. Mononeuropathy of the posterior interosseous nerve: compression by return radial arteries. Questions of neurosurgery named after N.N. Burdenko 2019; No. 5, p. 78-82. doi:10.17116/neiro20198305178;

28. Cha J, York B, Tawfik J. Posterior interosseous nerve compression. Eplasty. 2014 Jan 31; 14:ic4. PMID: 24570771; PMCID: PMC3919107;

29. Dididze M, Tafti D, Sherman Al. Pronator Teres Syndrome. Stat-Pearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan.;

30. Dydyk A.M., Negrete G., Sarwan G., Cascella M. Median Nerve Injury. StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan; PMID: 31971749;

31. Asheghan M, Hollisaz MT, Aghdam AS, Khatibiaghda A. The Prevalence of Pronator Teres among Patients with Carpal Tunnel Syndrome: Cross-sectional Study. Int J Biomed Sci. 2016 Sep;12(3):89-94. PMID: 27829824; PMCID: PMC5080413;

32. Hsiao CW, Shih JT, Hung ST. Concurrent carpal tunnel syndrome and pronator syndrome: A retrospective study of 21 cases. Orthop Traumatol Surg Res. 2017 Feb;103(1):101-103. doi: 10.1016/j.otsr.2016.10.009;

33. Binder H, Zadra A, Popp D, Komjati M, Tiefenboeck TM. Out-come of Surgical Treated Isolated Pronator Teres Syndromes-A Retrospective Cohort Study and Complete Review of the Literature. Int J Environ Res Public Health. 2021 Dec 22;19(1):80. doi: 10.3390/ijerph19010080;

34. Mehl A, Stevenson J, Royal JT, Lourie GM. Lacertus syndrome: Use of pre- and post-exercise MRI to aid in diagnosis and treatment. Radiol Case Rep. 2021 Mar 4;16(5):1113-1117. doi: 10.1016/j.radcr.2021.02.022. PMID: 33732403; PMCID: PMC7937939;

35. Karpinsky N.A., Zhigalo A.V., Morozov V.V. Our experience in the diagnosis and surgical treatment of patients with aponeurosis syndrome of the biceps shoulder muscle (lacertus syndrome). Medical assistance for injuries. New in organization and technology. the role of the national public professional organization of traumatologists in the health care system of the Russian Federation: the sixth All-Russian Congress with international participation: a collection of theses, St. Petersburg, February 26-27, 2021. - St. Petersburg: St. Petersburg public organization «Man and his health,» 2021; S. 62-63;

36. Hagert E. Clinical diagnosis and wide-awake surgical treatment of proximal median nerve entrapment at the elbow: a prospective study. Hand (N Y). 2013 Mar;8(1):41-6. doi: 10.1007/s11552-012-9483-4. PMID: 24426891; PMCID: PMC3574476;

37. Tang JB. Median nerve compression: lacertus syndrome versus superficialis-pronator syndrome. J Hand Surg Eur Vol. 2021 Nov;46(9):1017-1022. doi: 10.1177/17531934211024092. Epub 2021 Jul 2. PMID: 34210205


Review

For citations:


Zhogina M.A., Veber E.V. Differential diagnosis of the most common сompressive neuropathy of the upper limb. Department of Traumatology and Orthopaedics. 2023;(3):74-82. (In Russ.) https://doi.org/10.17238/2226-2016-2023-3-74-82

Views: 30

JATS XML


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2226-2016 (Print)