Reasons for using swelling ratio in sonographic diagnosis of carpal tunnel syndrome and a reliable method for its calculation

Abstract

We have developed a reliable SR method considering factors affecting median nerve CSA.

Bifid median nerve in carpal tunnel syndrome: Do we need to know?

“…Moreover, measurement at the point of greatest enlargement has a risk of increased false positives. 29 Because we did not identify the median nerve distal to the flexor retinaculum, it is possible that the number of bifid median nerves in our study is relatively underestimated. Finally, in patients, only the most symptomatic hand was examined electrodiagnostically, whereas both were examined ultrasonographically.…”

“…It is known, however, that cut‐off points, sensitivity and specificity values vary at different measurement locations. Moreover, measurement at the point of greatest enlargement has a risk of increased false positives . Because we did not identify the median nerve distal to the flexor retinaculum, it is possible that the number of bifid median nerves in our study is relatively underestimated.…”

Carpal tunnel syndrome: elastosonographic strain ratio andcross-sectional area evaluation for the diagnosis and disease severity.

“…The small number of men in both the CTS and control groups may have also been a limitation, because gender was shown to affect nerve thickness [38]. Finally due to the high specificity values of NCS, false positivity was not expected in patients with positive CTS results who were included in our CTS group.…”

The Association Between Bifid Median Nerve and Carpal Tunnel Syndrome: Is it Really a Risk Factor?

“…Participants in the control group were not examined with NCS if their median nerve CSA was <0.10 cm 2 at the level of the pisiform. Since the swelling ratio was demonstrated to be a more reliable sonographic method 8 in CTS diagnosis, patients with subclinical CTS with a median nerve CSA <0.10 cm 2 might be included in the control group instead of the CTS group. This situation may have an effect on the percentage of BMN's in the two groups, as the number of patients may change after reevaluation.…”

“…5,6 In the last decade, sonographic evaluation via high resolution linear transducers has emerged as a new diagnostic technique for diagnosing CTS and various musculoskeletal conditions. [7][8][9][10] A BMN refers to high division of the median nerve proximal to the carpal tunnel. 1 In previous studies, BMN was reported to be associated with CTS due to its relatively higher cross sectional area (CSA) compared to a non-BMN which may lead compression in carpal tunnel.…”