Assessment of subsynovial connective tissue thickness in carpal tunnel syndrome

The pathophysiology of carpal tunnel syndrome (CTS) is not completely understood. Commonly, it is thought to be a compression neuropathy. Recently there are also arguments that repetitive wrist and finger motions are part of the pathogenesis. A common histological finding in CTS is a non-inflammatory thickening of the subsynovial connective tissue (SSCT). These changes are more probable part of the cause of CTS than a consequence. As the SSCT helps mediating movement between median nerve and tendons, alterations in this structure may result eventually in damage of the nerve.

Electrodiagnostic (EDX) studies are often used in the diagnosis of carpal tunnel syndrome. However, some people with clinical signs of carpal tunnel syndrome will have a normal EDX study. Other diagnostic testing might be useful for early detection. As we believe that thickening of SSCT precedes EDX changes, measuring SSCT thickness may help in detecting early changes in carpal tunnel syndrome.

The general aim of this research is to investigate the morphology of the SSCT in healthy people, as well as in CTS patients. This could help in the diagnosis of CTS by refining a non-invasive assessment of carpal tunnel parameters. Next, it may be possible to categorize patients in subgroups (e.g. response to treatment), as well as to help find risk factors for developing CTS.