Ultrasound examination of peripheral nerve and joint involvement in hand-arm vibration syndrome: diagnostic and pathogenetic considerations

Hand-Arm Vibration Syndrome (HAVS) is characterized by polysymptomatic manifestations involving peripheral nerves, joints, and periarticular tissues. Ultrasonography (US) represents a promising diagnostic modality for detecting structural changes in HAVS, though existing studies remain fragmentary.

The aim of the study is to conduct a comprehensive evaluation of ultrasonographic changes in joints, periarticular tissues, and peripheral nerves in HAVS patients compared to controls, and analyze their correlation with clinical and electrophysiological parameters.

The study enrolled 89 HAVS patients (riveters, miners) and 39 control subjects. All participants underwent clinical examination, electroneuromyography (ENMG), and US assessment of upper extremities including evaluation of wrist, elbow, and shoulder joints, periarticular tissues, and peripheral nerves.

HAVS patients demonstrated significantly higher prevalence of carpal tunnel syndrome (39.1% vs 16.1%, p=0.02). Compared to controls, they showed increased cross-sectional area (CSA) of the median nerve at the carpal tunnel (11.1 mm² vs 9.55 mm², p=0.004) and greater perineurium thickness (0.7 mm vs 0.5 mm, p=0.001). Median nerve CSA correlated with vibration exposure duration (r=0.188, p=0.015) and HAVS severity (p<0.001). Increased ulnar nerve CSA was associated with elbow osteoarthritis (p=0.031) and epicondylitis (p=0.023).

US reveals specific pathological changes in HAVS. Diffuse median nerve enlargement without compression signs may serve as a potential diagnostic marker for HAVS.

Limitations. Study limitations include relatively small sample size, lack of assessment for individual movement patterns, and restricted US methodology.

Ethics. The study protocol was approved by the Local Ethics Committee of East-Siberian Institute of Medical and Ecological Research (Protocol No. 2 dated March 17, 2025).

Contributions:
Zueva Y.I. — concept and design of the study, data collection and processing, statistical analysis, writing the text, and editing;
Lakhman O.L. — concept and design of the study, editing of the article;
Rusanova D.V. — collection of material and data processing, editing of the article;
Slivnitsyna N.V. — material collection and data processing.
All co-authors — approving of the final version of the article and ensuring the integrity of all parts of the article.

Funding. Funding was provided as part of the implementation of the State assignment for fundamental scientific research.

Conflict of interest. The author declares no conflict of interest.

Received: 26.07.2025 / Accepted: 26.08.2025 / Published: 05.10.2025

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