Evaluation of the median nerve within the wrist during functional hand activity using ultrasonography

• Main Author: Langley, Alyson
• Published: University of Nottingham 2010
• Subjects: 615.84; RC Internal medicine
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.528189

Over the last 20 years, an increasing number of research studies have shown that ultrasonography can provide a valid and accurate assessment of the median nerve and the pathological changes associated with median nerve disorders. More recently ultrasonographic technology has advanced and it now allows for dynamic imaging of the nerve during physical movement of the hand. However dynamic ultrasonographic imaging is still a relatively new application as is yet to be explored to its full potential in the study of median nerve dynamics and the associated pathological changes. The primary aim of this research is to study median nerve activity during physical hand movement using ultrasonography with 8-16MHz linear array transducer. The objectives are to establish an ultrasonographic technique for the dynamic imaging of the median nerve, along with an analytical method that can quantify its changing size, shape and location during four hand movements. The data obtained from participants with normal median nerve function is compared to values from participants who are either moderately symptomatic or fully symptomatic of a median nerve disorder, to investigate whether the novel method and technique could distinguish between the groups. Three studies were designed to investigate median nerve activity during physical movement using ultrasonography. The aim of the first study was to investigate if the novel quantification method and ultrasonographic technique could measure the changing parameters of the median nerve between the start and end positions of a finger grip, power grip, pinch grip and thumb opposition movement, in non-symptomatic participants who have normal median nerve function. The second study investigated whether the novel quantification method and ultrasonographic technique could distinguish between the non-symptomatic participants and participants who are either moderately symptomatic or fully symptomatic of a median nerve disorder, during each movement. The third study examined the change in size, shape and location of the median nerve at five intervals during the four movements and compared the data obtained from the non-symptomatic group with the values obtained from the moderate and fully symptomatic groups. The findings from the studies show that the dynamic ultrasonographic technique can be used to image the median nerve during physical activity of the hand and that the novel quantification method can be used to measure the change in the parameters of the median nerve during physical hand activity and distinguish significant differences between the non-symptomatic median nerve and those symptomatic of an median nerve disorder.