ULTRASONIC ASSESSMENT OF EXTENSOR, FLEXOR, INTRINSIC THENAR MUSCLES GROUP AND NERVES OF WRIST JOINT IN PATIENTS OF HYPOTHYROIDISM

Abstract

Introduction: Hypothyroidism is a common endocrine disorder associated with a wide range of musculoskeletal and neuromuscular complications, particularly involving the wrist and hand. Conditions such as CTS, tendon abnormalities and muscle atrophy are frequently reported but often remain underdiagnose. MSUS has emerged as noninvasive, cost effective and dynamic imaging modality that allows real time assessment of muscles, tendons, joints and nerves.

 Aim of the study: This study aims to assess the role of MSUS in evaluating extensor, flexor and intrinsic thenar muscle groups, nerves changes in patients with hypothyroidism and to compere these findings with healthy controls. Methodology: A comparative cross-sectional study will be conducted over a period of 4 months at NIH&RC. A total sample consisting of hypothyroid patients (GROUP A) and healthy controls (GROUP B) will be included. Age participants aged 18-60 years clinically and biochemically confirmed hypothyroidism will be selected based on inclusion and exclusion criteria. High frequency ultrasound (7-15 MHz linear probe) will be used to assess muscle thickness, echotexture and contractility, along wrist joint features such as effusion, synovial hypertrophy and tendon abnormalities. Median nerve cross sectional area (CSA) at the carpal tunnel inlet will also be measured. Data will be analyzed using SPSS, applying appropriate statistical tests with a significant level of p<0.05.

Results: A total of 64 participants were included, comprising both hypothyroid patients and healthy controls. Most participants were female (62.5%) and belonged to the 21–40 years’ age group. Right-sided involvement was most common, and most patients reported symptoms lasting more than 3 months. On ultrasound, swelling was the most frequent finding (n = 50), while synovial thickening (n = 14) and increased vascularity (n = 4) were less common. Clinically, wrist pain, numbness, and tenderness were reported in a smaller proportion of participants, while effusion and trauma history were rare. Statistical analysis showed a significant difference in swelling between groups (t = 4.91, p < .001), confirming higher swelling in the affected group.

Conclusion: This study concludes that hypothyroidism significantly affects wrist joint structures, including muscles, tendons, and the median nerve, leading to conditions such as CTS. MSUS is an effective, non-invasive imaging modality for early detection. Its use can improve diagnosis, guide management, and reduce complications in hypothyroid patients