ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH SIÊU ÂM HỘI CHỨNG ỐNG CỔ TAY Ở BỆNH NHÂN GÚT MẠN TÍNH

Abstract

Aim: Description of the clinical characteristics and images of ultrasound of chronic gout patients with carpal tunnel syndrome (CTS). Subjects and methods: Cross-sectional description of 32 patients with chronic gout with 54 carpal tunnels diagnosed with CTS according to the standards of the American Neurological Association who came for examination and treatment at the Musculoskeletal Center of Bach Mai Hospital from August 2023 to April 2024. Result: The mean age of the patients  was  58,5 ±10,3, in there 100% were male. The median duration of gout was 9.69 ± 4.34(years). The median duration of carpal tunnel syndrome was 12.94 ± 8.6(months). The main reason for examination was numbness of the hand (81.2%). Clinical symptoms of the diseased hand: 53.7% pain in the wrist and hand, 87.0% triggering factors, 96.3% paresthesia, 70.3% decreased sensation, 11.1% loss of sensation, 44.4% anti-finger movement, weak grip, 42.6% atrophy of the thenar muscles. The rate of Phalen test (+) is 83.3% of carpal tunnels, Tinel sign (+) is 72.2%, Duncan test (+) is 68.5%. There were 75.9% of carpal tunnels with Notch signs (+), 16.7% reverse Notch signs (+), 79.6%  median nerve edema. The median nerve area proximal to the carpal  tunnel  averaged 9.7± 2.08(mm²). Characteristics of wrist joint damage on ultrasound in patients with chronic gout: 72.2% synovitis, 87.0% tophi, 25.9% double contour sign, 24.0% bone erosion. Conclusion: Common clinical symptoms of carpal tunnel syndrome in patients with chronic gout are manifestations of damage to the median nerve. Ultrasound helps evaluate images of the median nerve and damage to the wrist joint in patients with chronic gout