Sex differences in carpal tunnel syndrome using person reported outcomes and

腕管综合征(CTS)是最常见的周围神经卡压障碍 (手腕正中神经)，也是现代最流行的上肢肌肉骨骼之一 精神错乱。尽管其流行，但cts背后的确切病因和病理生理学目前尚不清楚。 这个项目将解决这些知识上的差距，并有助于加深我们对 疾病机制，从而通过提供预防措施来改善CTS患者的整体临床护理 措施或替代治疗策略。这项拟议的研究对于CTS领域是新颖的，并且代表了 最大的自然历史研究结合了最先进的高分辨率超声(HRUS)和 电诊断/肌电图(EDX)方法学。我们将跟随一群雌性和雄性 采用前瞻性自然史研究设计的特发性CTS，为期6周的“标准护理” 保守治疗腕部夹板，并随访12个月，达到以下目的。目标1：实现 特发性CTS女性与非特发性CTS患者的基线HRUS特征比较 (根据年龄和BMI进行调整)，以及有和没有特发性CTS的男性(根据年龄和BMI进行调整)。目标2： 按性别确定和比较新的HRUS特征和患者报告的结果的能力 CTS中检测男性治疗前后疗效变化的措施和 标准夜间中性手腕夹板治疗6周后的女性；并评估与 CTS严重程度和进展的其他传统测量方法(如手动图、敏感度 测试、挑衅动作和EDX参数)。目标3：确定并比较患者 特征(年龄、性别、BMI、腕部人体测量、与工作相关的风险因素)、与健康相关的生活质量 CTS严重程度的测量和临床测量(物理测量、电诊断和超声检查 参数)与特发性CTS的短期和长期结果有关。 相关性(请参阅说明)： 标准化高分辨率超声方法学的建立及检测方法的确定 腕管综合征的诊断和监测能力将不仅对 对腕管综合征患者的医疗保健也将产生深远的影响 社会的医疗成本和提高的经济生产力。

Carpal tunnel syndrome (CTS) is the most frequently occurring peripheral nerve entrapment disorder (median nerve at the wrist) and is also one of the most prevalent modern-age upper limb musculoskeletal disorders. Despite its prevalence, the exact etiology and pathophysiology underlying CTS is unclear at this time.This project will address these gaps in knowledge and contribute to furthering our understanding of disease mechanism, and thereby improve the overall clinical care of patients with CTS by offering preventive measures or alternative therapeutic strategies. The proposed study is novel for the CTS field, and represents the largest natural history study incorporating the state-of-the-art high-resolution ultrasound (HRUS) and electrodiagnosis/electromyography (EDX) methodologies. We will follow a cohort of females and males with idiopathic CTS using a prospective natural history study design with 6 weeks of 'standard-of-care' conservative wrist splint treatment, and follow up for 12 months with the following aims. Aim 1: To determine and compare the baseline HRUS characteristics in females with and without idiopathic CTS (adjusted for age and BMI), and in males with and without idiopathic CTS (adjusted for age and BMI). Aim 2: To determine and compare by sex the ability of novel HRUS characteristics and patient-reported outcome measures in CTS to detect treatment effect changes between the pre- and post-treatment in men and women after 6 weeks of standard nocturnal neutral wrist splint treatment; and evaluate for correlation with other traditional measures of CTS severity and progression (as measured by hand diagram, sensibility testing, provocative maneuvers, and EDX parameters). Aim 3: To determine and compare the patient characteristics (age, sex, BMI, wrist anthropometrics, job-related risk factors), health-related quality of life measures, and clinical measures for CTS severity (physical measures, electrodiagnostic and sonographic parameters) in relation to short- and long-term outcomes in idiopathic CTS. RELEVANCE (See instructions): Establishment of standardized high-resolution ultrasound methodologies and determination of test capabilities in the diagnosis and monitoring of carpal tunnel syndrome will have important impact not only in health care of individuals with carpal tunnel syndrome but will also have far-reaching implications of reduced healthcare cost to society and increased economic productivity.