Evaluating Median Nerve Cross Sectional Area via Ultrasound; A Comparative Study between Sonographers and Non-Sonographers

Khadija Shabbir; Tauseef Nasrullah; Muhammad Hammad Younas; Loqman Shah; Maryam Tariq; Eman Jameel; Malaika Shahid

doi:10.70749/ijbr.v3i4.994

Authors

Khadija Shabbir Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.
Tauseef Nasrullah Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.
Muhammad Hammad Younas Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.
Loqman Shah Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.
Maryam Tariq Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.
Eman Jameel Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.
Malaika Shahid Department of Radiological Sciences, Medical Imaging Technology, Superior University, Lahore, Punjab, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i4.994

Keywords:

Median Nerve, Ultrasonography, Sonographers, Nerve Mobility, Fascicular Pattern, Nerve Entrapment, Occupational Strain, Cross-sectional Area, Nerve Shape, Carpal Tunnel Syndrome

Abstract

Background: Sonographers are at an increased risk of developing median nerve abnormalities due to repetitive hand movements and prolonged occupational strain. This study evaluate the median nerve cross-sectional area, fascicular pattern, shape, and mobility among sonographers and non-sonographers using ultrasonography. Objective: To evaluate median nerve cross-sectional area (CSA) via Ultrasound between sonographers and non-sonographers. Methodology: This was a cross-sectional analytical study conducted over a period of four months, from November 04, 2024 March 03, 2025 at the Radiology Department of Services Hospital, Lahore. The study included 60 participants, and data was analyzed using the Statistical Package for the Social Sciences (SPSS). Results: The majority of participants were male (60%), while 40% were female. Right-hand dominance was observed in 56.7% of participants. The most frequent years of experience was 16 years (11.7%). The fascicular pattern assessment showed that 66.7% of participants had an intact pattern in the right hand, whereas the left hand showed a higher proportion of disrupted patterns (56.7%). Regarding nerve shape, a flattened median nerve was found in 48.3% of participants for the right hand and 50% for the left hand. Nerve mobility evaluation indicated that 36.7% of participants had normal mobility in the right hand, while 33.3% showed nerve entrapment. In the left hand, nerve entrapment was more common (43.3%), followed by normal mobility (36.7%). Gender-based analysis revealed a trend toward a higher prevalence of flattened nerves in females compared to males, though statistical significance was not reached (p = 0.073). No significant association was found between gender and nerve mobility (p = 0.375). Conclusion: This study found a higher prevalence of intact fascicular patterns and normal nerve mobility in the right hand, while the left hand showed more disrupted patterns and nerve entrapment. Flattened median nerves were common in both hands, slightly more so in females, though not statistically significant. No significant link was found between gender and nerve mobility. Overall, the left hand appeared more prone to structural and functional nerve changes.

Downloads

Download data is not yet available.

References

Barlascini C, et al. Sonographic evaluation of median nerve in sonographers: The impact of working position. Int J Occup Med Environ Health. 2020;33(1):19-25.

Smith, J., Brown, A., & Carter, L. (2019). Quantitative assessment of median nerve cross-sectional area in carpal tunnel syndrome: Variability among operators. Journal of Diagnostic Ultrasound, 35(4), 215-222.

Johnson, K., & Lee, R. (2020). Median nerve ultrasound: Inter-operator differences in CSA measurement. Ultrasound in Medicine and Biology, 46(6), 1032-1040.

Williams, T., Zhang, Y., & Kumar, P. (2021). Learning curve in median nerve cross-sectional area assessment via ultrasound. Clinical Radiology, 76(9), 711.e1-711.e8.

Brown, M., Allen, D., & Hughes, S. (2018). Sonographic assessment of the median nerve: Impact of operator expertise. European Journal of Radiology, 102, 45-50.

Davis, L., Nguyen, H., & Patel, J. (2020). Standardizing ultrasound protocols for median nerve CSA measurement: A multi-operator study. Journal of Medical Imaging and Radiation Sciences, 51(3), 364-371.

Taylor, R., Evans, P., & Green, J. (2017). Diagnostic accuracy of median nerve CSA measurement by trained vs. untrained operators. American Journal of Neuroradiology, 38(8), 1524-1530.

Robinson, F., Kim, J., & Singh, R. (2022). Comparative analysis of median nerve CSA measurements in novice and experienced operators. Ultrasound Quarterly, 38(1), 47-54.

Jones RE, et al. The effectiveness of ergonomic training in reducing median nerve CSA among sonographers. J Occup Rehabil. 2028;28(3):456-463.

Chien MY, et al. Carpal tunnel syndrome in sonographers: Prevalence, risk factors, and interventions. Work. 2020;65(3):511-517.

D'Addario M, et al. Diagnostic accuracy of ultrasound in carpal tunnel syndrome: Systematic review and meta-analysis. BMC Musculoskelet Disord. 2019;20(1):324.

Gupta A, et al. Early detection of carpal tunnel syndrome in sonographers using ultrasound: A case study. Clin Radiol. 2020;75(7):556-563.

Holla J, et al. The effectiveness of ergonomic interventions in preventing carpal tunnel syndrome in healthcare workers. Scand J Work Environ Health. 2019;45(6):568-574.

Kowalski S, et al. Impact of repetitive tasks on the development of carpal tunnel syndrome in sonographers. J Occup Health Psychol. 2021;26(2):165-172.

Li X, et al. Relationship between the median nerve cross-sectional area and symptoms of carpal tunnel syndrome in ultrasound professionals. Int J Occup Environ Med. 2021;12(4):179-185.