ORIGINAL ARTICLE Role of Anthropometric Characteristics in Idiopathic Carpal Tunnel Syndrome Konstantinos Chiotis, MD, a Nikolaos Dimisianos, MD, a Aspasia Rigopoulou, MD, PhD, b Athina Chrysanthopoulou, MD, PhD, b Elisabeth Chroni, MD, PhD a From the a Department of Neurology and b Department of Radiology, University Hospital of Patras, Patras, Greece. Abstract Objective: To investigate the possible association of external and ultrasonographic measurements of the hand and wrist with median nerve conduction studies. Design: Two group comparison study. Setting: Outpatient neurophysiology laboratory and radiology department in a university hospital. Participants: Patient group (nZ50; 40 women) with clinically overt and electrophysiologically proven idiopathic carpal tunnel syndrome and a control group of age- and sex-matched healthy volunteers (nZ50). Interventions: Not applicable. Main Outcome Measures: The following measurements were taken: (1) motor and sensory conduction studies of the median nerve; (2) external hand and wrist dimensions (hand ratio and wrist ratio); and (3) ultrasonographic dimensions of the carpal tunnel (carpal tunnel inlet ratio and carpal tunnel outlet ratio) and inlet cross-sectional area and outlet cross-sectional area of the median nerve at the tunnel. Results: Differences between patients and controls were significant for hand and wrist ratios and all ultrasonographic dimensions. Sensory conduction velocity and distal motor latency of the median nerve in all 100 subjects were well correlated with hand ratio, wrist ratio, carpal tunnel inlet ratio, and carpal tunnel outlet ratio estimates. Wrist ratio was significantly correlated with carpal tunnel inlet ratio and carpal tunnel outlet ratio. Conclusions: A particular hand and wrist configuration, that is, short and wide hand with square wrist matching to narrow and deep tunnel entrance demonstrated increased liability for idiopathic carpal tunnel syndrome. For screening purposes, it was suggested that simple external hand or wrist measurements could be used to predict the tendency for carpal tunnel syndrome. Archives of Physical Medicine and Rehabilitation 2013;94:737-44 ª 2013 by the American Congress of Rehabilitation Medicine Carpal tunnel syndrome (CTS) is a result of compression of the median nerve as it passes through the nonflexible carpal tunnel, where increased pressure, ischemia, and/or inflammation lead primarily to segmental demyelination and consequently to secondary axonal damage. 1 CTS-related morbidity leading to the loss of working hours, medical expenses for surgical nerve decompression, compensation claims, and the occasionally permanent compromise of thumb movements has substantial socioeconomic and health care consequences. 2,3 CTS is a very common condition accounting for almost 90% of all entrapment neuropathies in the upper limbs and has an incidence of 2 for 1000 person-years in the general population. 1,4 It occurs during people’s productive life, compromising the use of their hands; symptoms often persist for many months (sleepless nights) prior to seeking medical help, and even the postoperative recovery period requires a long time off work. Therefore, any markers or signs for predicting the tendency to develop CTS would be useful. Although hand injury and several medical conditions, such as diabetes, rheumatoid arthritis, pregnancy, and renal failure, are predisposing factors to this syndrome, the majority of cases occur without any obvious causes, and this is considered idiopathic Presented to the European Federation of Neurological Societies Congress, September 9e12, 2012, Stockholm, Sweden. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. 0003-9993/13/$36 - see front matter ª 2013 by the American Congress of Rehabilitation Medicine http://dx.doi.org/10.1016/j.apmr.2012.11.017 Archives of Physical Medicine and Rehabilitation journal homepage: www.archives-pmr.org Archives of Physical Medicine and Rehabilitation 2013;94:737-44