Romatolojik hastalıklarda tuzak nöropatileri: Epidemiyoloji, tanı ve ayırıcı tanı

Arzu Yağız On

doi:10.19161/etd.863703

EN TR

Entrapment neuropathies in rheumatologic diseases: Epidemiyology, diagnosis and differential diagniosis

Abstract

Entrapment neuropathies are commonly seen in rheumatologic diseases, due to the mechanical compression of the peripheral nerves as a result of joint deformities and inflammation of the synovium, ligaments, tendons and bursae. Although clinical findings, diagnosis and treatments are similar to those without rheumatologic disease, pain and joint limitations may cause difficulties in clinical examination and differential diagnosis. Commonly seen entrapment neuropathies in rheumatologic diseases are carpal tunnel syndrome, tarsal tunnel syndrome, cubital tunnel syndrome and Morton’s neuroma. Clinical findings and electrophysiological investigations are essential for diagnosis and differential diagnosis. Magnetic Resonance Imaging and Ultrasonography are also helpful. Polyneuropathies, plexopathies and radiculopathies should be mainly considered in differential diagnosis.

Keywords

Romatolojik hastalıklarda tuzak nöropatileri: Epidemiyoloji, tanı ve ayırıcı tanı

Öz

Romatolojik hastalıklarda sinovyum, ligament, tendon ve bursaların inflamasyonuna ve eklem deformitelerine bağlı olarak, periferik sinirlerin mekanik kompresyona uğramaları nedeniyle tuzak nöropatileri sıklıkla görülmektedir. Klinik, tanı ve tedavi romatolojik hastalığı olmayan bireylerle benzer olmakla birlikte, ağrı ve eklem kısıtlılıkları klinik muayene ve ayırıcı tanıda güçlüklere yol açabilmektedir. En sık görülen tuzak nöropatileri karpal tünel sendromu, tarsal tünel sendromu, kübital tünel sendromu ve Morton metatarsaljisidir. Tanıda klinik bulgular ve elektrofizyolojik incelemeler esastır. Manyetik Rezonans ve Ultrasonografik görüntüleme de yardımcıdır. Ayırıcı tanıda başlıca polinöropatiler, pleksopatiler ve radikülopatiler akla gelmelidir.

Anahtar Kelimeler

Kaynakça

Aktekin LA, Gözlükaya H, Bodur H, Borman P, Köz Ö. Peripheral neuropathy in rheumatoid arthritis patients;an electroneurophysiological stüdyo. Turk J Rheumatol 2009; 24 (1): 62-6.
Nadeau SE. Neurologic manifestations of connective tissue disease. Neurol Clin 2002; 20 (2): 151-9.
Rosenbaum R. Neuromuscular complications of connective tissue diseases. Muscle Nerve 2001; 24 (2): 154-69.
Herbison GJ, Teng C, Martin JH, Ditunno JF. Carpal tunnel syndrome in rheumatoid arthritis Am J Phys Med 1973; 52 (2): 68-74.
Craig EV, House JH. Dorsal carpal dislocation and flexor tendon rupture in rheumatoid arthritis: a case report. J Hand Surg 1984; 9A: 261-4.
Gray RG, Gottlieb NL. Hand flexor tenosynovitis in rheumatoid arthritis. Prevalence, distribution, and associated rheumatic features. Arth Rheum 1977; 20 (1): 1003-8.
Lee KH, Lee CH, Lee BG. The incidence of carpal tunnel syndrome in patients with rheumatoid arthritis. Int J Rheum Dis 2015; 18 (1): 52-7.
Chamberlain MA, Corbett M. Carpal tunnel syndrome in early rheumatoid arthritis. Ann Rheum Dis 1970; 29 (3): 149-52.

Fleming A, Dodman S, Crown JM, Corbett M. Extra-articular features in early rheumatoid disease. Br Med J 1976; 22 (1): 1241-3.
Moran H, Chen SL, Muirden KD, et al. A comparison of rheumatoid arthritis in Australia and China. Ann Rheum Dis 1986; 45 (3): 572-8.
Wells RM, Johnson EW. Study of conduction delay in median nerve of patients with rheumatoid arthritis. Arch Phys Med Rehabil 1962; 43 (1): 244-8.
Rosenbaum RB, Ochoa JL. Carpal Tunnel Syndrome and Other Disorders of the Median Nerve. Philadelphia: WB Saunders Company, 1986: 36-56.
Lau JT, Daniels TR. Tarsal tunnel syndrome: a review of the literature. Foot Ankle Int 1999; 20 (3): 201-9.
Baylan SP, Paik SW, Barnert AL, Ko KH, Yu J, Persellin RH. Prevalence of tarsal tunnel syndrome in rheumatoid arthritis. Rheumatol Rehabil 1981; 20 (2): 148-50.
Lloyd K, Agarwal A. Tarsal‐tunnel syndrome, a presenting feature of rheumatoid arthritis. BMJ 1970; 3 (5713): 32.
KhalilIbrahim I, Medani SF, El-Hameed MMA, Imam MH, Shaaban MMA. Tarsal tunnel syndrome in patients with rheumatoid arthritis, electrophysiological and ultrasound study. Alexandria J Med 2013; 49 (4): 95-104.
Grabois M, Puentes J, Lidsky M. Tarsal tunnel syndrome in rheumatoid arthritis. Arch Phys Med Rehabil 1981;62 (8):401-3.
McGuigan L, Burke D, Fleming A. Tarsal tunnel syndrome and peripheral neuropathy in rheumatoid disease. Ann Rheum Dis 1983; 42 (2): 128-31.
El-Hewala ASI, Soliman SG, Labeeb AA, Zytoon AA, El-Shanawany AT. Foot neuropathy in rheumatoid arthritis patients: clinical, electrophysiological, and ultrasound studies. Egypt Rheumatol Rehabil 2016; 43 (2): 85-94.
Awerbuch MS, Shephard E, Vernon-Roberts B. Morton’s metatarsalgia due to Intermetatarsophalangeal bursitis as an early manifestation of rheumatoid arthritis. Clin Orthop Relat Res 1982; 167 (1): 214-21.
Vainio K (1979) Morton’s metatarsalgia in rheumatoid arthritis. Clin Orthop Relat Res 1979; 142 (3): 85-9.
Chaganti S, Joshy S, Hariharan K, Rashid M. Rheumatoid nodule presenting as Morton's neuroma. J Orthop Traumatol 2013; 14 (3): 219-22.
Özçete ZA, On AY. Ulnar Sinir Tuzak Nöropatileri. Turk J Phys Med Rehab 2010;56(2):190-5
deAndrade JR, Casagrande PA. Ulnar nerve entrapment in rheumatoid arthritis: a case report. Arthritis Rheum 1965;8 (1): 294-301.
Helliwell P. Clinical features of the foot in rheumatoid arthritis. In: Helliwell P, Woodburn J, Redmond A, Turner D, Davys H (eds). The foot and ankle in rheumatoid arthritis. 1st ed. Edinburgh: Churchill Livingstone/Elsevier; 2007: 5774.
Nakano K. Entrapment neuropathy from Baker's cyst. JAMA 1978; 239 (2): 135.
Ishikawa H, Hirohata K. Posterior insterosseous nerve syndrome assoicated with rheumatoid synovial cysts of the elbow joint. Clin Orthop 1990; 254 (3): 134-9.
Létourneau L, Dessureault M, Carette S. Rheumatoid iliopsoas bursitis presenting as unilateral femoral nerve palsy. J Rheumatol 1991; 8 (1): 462-3.
Ogawa H, Akaike A, Ishimaru D. Posterior interosseous nerve palsy related to rheumatoid synovitis of the elbow. Mod Rheumatol 2007;17 (2): 327-9.
Agarwal V, Singh R, Wiclaf, et al. A clinical, electrophysiological, and pathological study of neuropathy in rheumatoid arthritis. Clin Rheumatol 2008; 27 (7): 841-4.
Good AE, Christopher RP, Koepke GH, Bender LF, Tarter MF. Peripheral neuropathy associated with rheumatoid arthritis. A clinical and electrodiagnostic study of 70 consecutive rheumatoid arthritis patients. Ann Intern Med 1965; 63 (1): 87-99.
Salvarani C, Cantini F, Macchioni P, et al. Distal musculoskeletal manifestations in polymyalgia rheumatica: a prospective followup study. Arthritis Rheum 1998; 41 (7): 1221-6.
Salvarani C, Hunder GG. Musculoskeletal manifestations in a population‐based cohort of patients with giant cell arteritis. Arthritis Rheum 1999; 42 (6): 1259-66.
Said G. Necrotizing peripheral nerve vasculitis. Neurol Clin 1997;15 (4): 835-48.
Omdal R, Mellgren SI, Husby G. Clinical neuropsychiatric and neuromuscular manifestations in systemic lupus erythematosus. Scand J Rheumatol 1988; 17 (2): 113-7.
Sivri A, Hasçelik Z, Çeliker R, Basgöze O. Early detection of neurological involvement in systemic lupus erythematosus. Electromyogr Clin Neurophysiol 1995; 35 (2): 195-9.
İrdesel J. Median sinir tuzak nöropatileri. In: Sarıdoğan M (ed). Üst Ekstremite Tuzak Nöropatileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2019: 11-21.
Bacle G, Marteau E, Corcia P, Garaud P, Laulan J. Are carpal tunnel syndrome and regional degenerative osteoarthritis linked? Results of a case-control study. J Hand Surg Asian Pac 2018; 23 (1): 41-6.
MacDermid JC, Wessel J. Clinical diagnosis of carpal tunnel syndrome: a systematic review. J Hand Ther 2004; 17 (3): 309-19.
Yagiz A, Efendi H, Hepgüler S. Karpal tünel sendromunda kullanılan klinik testlerin tanısal değerleri. Nörol Bil Derg 1995;12 (3): 59-65.
Gellman H, Gelberman RH, Tan AM, Botte MJ. Carpal tunnel syndrome. An evaluation of the provocative diagnostic tests. J Bone Joint Surg Am 1986; 68 (5): 735-7.
Phalen GS. The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin Orthop Relat Res. 1972; 83 (3): 29-40.
Werner RA, Bir C, Armstrong TJ. Reverse Phalen’s maneuver as an aid in diagnosing carpal tunnel syndrome. Arch Phys Med Rehabil. 1994; 75 (7): 783-6.
Stevens JC. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve. 1997; 20 (12): 1477-86.
Akyüz M, Karataş G. Üst ekstremite tuzak nöropatilerinde elektrofizyolojik değerlendirme. In: Sarıdoğan M (ed). Üst Ekstremite Tuzak Nöropatileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2019: 46-57.
Barnes CG, Currey HL. Carpal tunnel syndrome in rheumatoid arthritis. A clinical and electrodiagnostic survey. Ann Rheum Dis 1967; 26 (1): 226-33.
Lanzillo B, Pappone N, Crisci C, di Girolamo C, Massini R, Caruso G. Subclinical peripheral nerve involvement in patients with rheumatoid arthritis. Arthritis Rheum 1998; 41(4): 1196-202.
Sivri A, Guler‐Uysal F. The electroneurophysiological findings in rheumatoid arthritis patients. Electromyogr Clin Neurophysiol 1999; 39 (3): 387-91.
Bland JD. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve. 2000; 23 (8): 1280-3.
Palamar D. Tuzak nöropatilerinde ultrasonografik inceleme. In: Sarıdoğan M (ed). Üst Ekstremite Tuzak Nöropatileri. 1. Baskı. Ankara: Türkiye Klinikleri 2019: 58-68.
Kaymak B, Özçakar L, Çetin A, Çetin MC, Akıncı A, Hasçelik Z. A comparison of the benefits of sonography and electrophysiologic measurements as predictors of symptom severity and functional status in patients with carpal tunnel syndrome. Arch Phys Med Rehabil 2008; 89 (4): 743-8.
On AY. Travmatik periferik sinir yaralanmaları. In: Beyazova M, Kutsal YG (Eds). Fiziksel Tıp ve Rehabilitasyon. Ankara: Güneş Tıp Kitabevleri: 2016: 2449-64.
Novak CB, Lee GW, Mackinnon SE, Lay L. Provocative testing for cubital tunnel syndrome. J Hand Surg Am 1994; 19 (4): 817-20.
Kuschner SH, Ebramzadeh E, Mitchell S. Evalution of elbow flexion and Tinel tests for cubital tunnel syndrome in asymptomatic individuals. Orthopedics 2006; 29 (1): 305-8.
Campbell WW. Guidelines in electrodiagnostic medicine. Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow. Muscle Nerve Suppl 1999;8: 171-205.
Korkmaz M, On AY, Caliş FA. Reference data for ulnar nerve short segment conduction studies at the elbow. Muscle Nerve. 2011; 44 (5): 783-8.
Yalcinkaya S, Atamaz Calis F, Ozdemir O, Kucuk L, Gunay H, On AY. The value of short segment conduction studies in localizing ulnar neuropathy of the elbow. Hand Microsurg 2017; 6 (3): 68-74.
Mondelli M, Morana P, Padua L. An electrophysiological severity scale in tarsal tunnel syndrome. Acta Neurol Scand 2004; 109 (3): 284–9.
Oh SJ, Sarala PK, Kuba T, Elmore RS.Tarsal tunnel syndrome; electrophysiological study. Ann Neurol 1979; 5 (3): 32 7-30.
Abouelela AA, Zohiery AK. The triple compression stress test for diagnosis of tarsal tunnel syndrome. Foot (Edinb) 2012; 22 (3): 146-9.
On AY, Erer F, Akşit R. Morton’s metatarsalji elektrofizyolojik tanısında invaziv olmayan yeni bir teknik. J Rheum Med Rehab 1999; 10 (2): 127-32.
Ata AM. Onat ŞŞ Özçakar L. Ultrasound-guided diagnosis and treatment of Morton's neuroma. Pain Physician 2016; 19 (2): E355-8.

Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Olgu Sunumu

Yazarlar

Arzu Yağız On ^*
0000-0002-7305-0186
Türkiye

Yayımlanma Tarihi

20 Ocak 2021

Gönderilme Tarihi

6 Nisan 2020

Kabul Tarihi

28 Ağustos 2020

Yayımlandığı Sayı

Yıl 2021

DOI

https://doi.org/10.19161/etd.863703

IZ

https://izlik.org/JA36WM92DX

Kaynak Göster

RIS / Bibtex

Vancouver

1.Arzu Yağız On. Romatolojik hastalıklarda tuzak nöropatileri: Epidemiyoloji, tanı ve ayırıcı tanı. ETD. 01 Ocak 2021;1-8. doi:10.19161/etd.863703