Utilization of Musculoskeletal Sonography in Detecting Physiologic Changes of the Median Nerve in a Working Animal Model

Currently the gold standard for the diagnosis of carpal tunnel syndrome (CTS) is through the use of nerve electrodiagnostic testing (EDX). The diagnosis is characterized by a drop in sensory and motor function within the median nerve. This increase in nerve dysfunction is associated with tissue injury, resulting from repetitive movements of the median nerve through the carpal tunnel. At this point of diagnosis inflammation or ischemic processes may have already begun compromising nerve function, both locally, and systemically. In order to prevent symptoms as severe and possibly irreversible such as these, the need for a method of earlier detection of median nerve trauma must be investigated. Utilizing musculoskeletal (MSK) sonography, it is hypothesized that earlier, less afflictive physiologic changes to the median nerve can be visualized and quantified, with the goal of providing enough pathophysiologic information to aid in the diagnosis of CTS. By detecting the microtrauma within the nerve, it may be possible for a CTS diagnosis to be made before tissue injury, as well as before a decrease in nerve sensory or motor function occurs. Through the use of gray-scale ultrasonography, geometric measurements of the median nerve can be obtained and analyzed, providing a quantitative representation of nerve size. Similarly, the spectral Doppler function possesses the capability of quantifying intraneural microvasculature within the median nerve, by obtaining peak systolic velocities (PSVs) throughout.These methods of using MSK sonography for early detection of symptoms related with CTS will be investigated through a longitudinal study involving an animal model. Two cohorts of macaca fascicularis monkeys will be used as participants in median mononeuropathy (MMN) research in which they will be exposed to a repetitive pinching task, putting them at risk for MMN. As the subjects move through the working and non-working stages of the study, MSK sonograms are performed longitudinally to allow for quantitative data comparison within each subject. Because the majority of evidence pertaining to the use of MSK sonography in aiding in the diagnosis of CTS exists only at the end stage of the disease process, a longitudinal examination of the disease progression would be the next logical step.

Name thesis:degree_name

Master of Science

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

Allied Medical Professions

Grantor dc:publisher

The Ohio State University

Year dc:date

2013

Author dc:creator

• Volz, Kevin R.

Contributors dc:contributor

• Evans, Kevin

• Radiology
• Medical Imaging
• Health Sciences
• Health Care
• Health
• median mononeuropathy
• MRI
• sonography
• wrist
• median nerve
• carpal tunnel syndrome
• spectral Doppler

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=osu1365003763

OAI identifier oai:identifier

oai:etd.ohiolink.edu:osu1365003763