Thermography in the diagnosis of carpal tunnel syndrome

Introduction - Carpal tunnel syndrome (CTS) is a condition caused by chronic compression of the median nerve. The diagnosis is made mainly on the basis of clinical image and confirmed with electrodiagnostic testing (electromyography and nerve conduction study); however, these methods do not always aid in reaching the diagnosis of CTS. Moreover, they are invasive examinations, unpleasant for the patient and have to be performed by a qualified physician. Aim - An evaluation of the usefulness of dynamic thermography in the diagnosis of CTS. Material and methods - Forty patients were included in the study group. CTS was diagnosed based on clinical examination and electromyography. Forty healthy volunteers were included in the control group. Each of the participants was examined thrice with dynamic thermography. The patient's hands were first cooled down and then a thermal camera measured their return to normal temperature. The measurement was repeated on the dorsal and volar aspects of each hand. Results - The results obtained in the study show that a relief of symptoms after carpal tunnel release does not correlate with thermal image. Moreover, the return to normal hand temperature was faster in the control group. In patients with unilateral CTS, no difference was observed in thermographic images of the affected and healthy hands. Conclusions - 1. Dynamic thermography can be useful in confirming CTS diagnosis. 2. Dynamic thermography does not allow for objective assessment of patient's complaints in the postoperative period. 3. This method has currently limited clinical application. Due to complexity, it presently serves mainly scientific purposes.