Ultrasonographic Assessment of Carpal Tunnel Syndrome

Ultrasonographic Assessment of Carpal Tunnel Syndrome in Children With Mucopolysaccharidosis and Comparison to Median Nerve Anatomy in Healthy Children.

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02196220

Enrollment

Registered

2014-07-21

Start date

2013-07-31

Completion date

2019-06-30

Last updated

2019-08-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Carpal Tunnel Syndrome

Brief summary

Mucopolysaccharidosis are lysosomal storage disorders such as Hunter, Hurler, and Sanfilippo syndromes. These patients have a genetic enzyme deficiency that results in the inability to degrade glycosaminoglycans. The glycosaminoglycans accumulate in lysosomes causing cell enlargement and subsequent dysfunction. The accumulation occurs in all tissues including cartilage, joint capsule, and tendons and can lead to carpal tunnel syndrome, trigger digits, and various other orthopaedic manifestations \[Van Heest, White\]. These children often suffer from severe cognitive impairment and are often unable to communicate pain or numbness. Carpal tunnel syndrome is almost always present, but may not become apparent until symptoms are severe and loss of function has occurred. The current gold standard for diagnosis consists of electromyographic (EMG) and nerve conduction velocity (NCV) studies under sedation or general anesthetic \[Khanna\]. Primary Objective: The investigators plan to correlate EMG findings and median nerve cross-sectional area in children with mucopolysaccharidosis. The investigators hypothesis is that ultrasonography of the carpal tunnel in patients with mucopolysaccharidosis will prove to be an effective, reliable, and safe method to evaluate the median nerve, thus avoiding the need for EMG studies and anesthesia. Secondary Objective: The investigators want to determine the cross-sectional area of the median nerve using ultrasonography in a cohort of healthy children, ages 3-12. The investigators plan to evaluate a cohort of healthy children to determine a normal cross-sectional area of the median nerve.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

3 Years to 12 Years

Healthy volunteers

Yes

Inclusion criteria

For the first arm of the study (25 participants): * Children with mucopolysaccharidosis presenting to the senior author's clinic with signs or symptoms of carpal tunnel syndrome will be enrolled to receive both an EMG and carpal tunnel ultrasound of the upper extremities. For the second arm of the study (100 participants): * Healthy children ages 3-12 with no acute upper extremity trauma or history of mucopolysaccharidosis. * 25 additional participants requested in case of inconclusive ultrasound results, patient removal, or other unusable results.

Exclusion criteria

First arm: * Children with mucopolysaccharidosis who have undergone previous treatment for carpal tunnel syndrome. Second arm: * Acute (\<3month) wrist or hand surgery/injuries. * Unable to obtain parental consent or patient assent. * History of mucopolysaccharidosis. * Non-english speaking. * Cognitive impairment.

Design outcomes

Primary

Measure	Time frame
Median nerve cross-sectional area in children with mucopolysaccharidosis and a cohort of healthy children, ages 3-12.	6-weeks after open carpal tunnel release

Countries

United States

Outcome results