Rheumatoid Arthritis and Carpal Tunnel Syndrome: Clinical Characteristics, Evaluation and Relation to Disease Parameters | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 101, Issue 1, October 2025, Pages 5221-5230 PDF (558 K) | ||
| DOI: 10.21608/ejhm.2025.460266 | ||
| Abstract | ||
| Background: Carpel tunnel syndrome (CTS) is one of the most prevalent extra-articular manifestations of rheumatoid arthritis (RA). The inflammatory and autoimmune nature of RA can predispose patients to this nerve entrapment neuropathy. Objective: This study aimed to assess the presence and severity of carpel tunnel syndrome (CTS) in a cohort of RA patients and explore its relationship with disease parameters. Subjects and methods: The study was conducted on 30 RA patients with clinical suspicion of CTS. Nerve conduction studies (NCS) were performed for the median nerve at wrist. Ultrasonography was used to measure the cross-sectional-area (CSA) and flattening ratio (FR) of median nerve and to assess the presence of local causes of compression. Result: This study included 30 RA patients, the mean age was 43.87± 11.99 years. The ultrasound measured CSA greater than 10 mm² at the wrist showed a statistically significant positive correlation with patient age (r=0.442, p=0.000), RA disease duration (r=0.237, p=0.032), CTS symptoms duration (r=0.363, p=0.004), CRP (r=0.386,p=0.002), RF (r=0.575, p=0.000) and anti-cyclic citrullinated peptide (ACCP) positivity (r=0.707, p=0.000). This assessment also showed a negative correlation with hemoglobin percentage (r=-0.256, p=0.047). CSA at wrist > 10 mm exhibited much higher specificity (85.7%) compared to FR > 3 (14.3%) in positive NCS, and the FR > 3 demonestrated higher sensitivity (78.3%) compared to CSA at wrist > 10 (39.1%). Conclusion: The frequency of CTS in RA patients was found to be higher than that observed in the general population, particularly in individuals with additional risk factors. There was significant relationship between CTS and current RA disease activity. CTS in RA patients was associated with longer disease duration suggesting that CTS is a consequence of the chronic course of RA disease. | ||
| Keywords | ||
| Rheumatoid arthritis; Carpal tunnel syndrome; US | ||
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