Sonographic measurement of cross‐sectional area of the median nerve in the diagnosis of carpal tunnel syndrome: Correlation with nerve conduction studies

Morán, Luz María; Pérez, María Jesús; Esteban, Ángel; Bellón, José M.; Arranz, Beatriz Arranz; Cerro, Miguel Del

doi:10.1002/jcu.20551

Cited by 122 publications

(102 citation statements)

References 21 publications

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“…However, sonography did not determine the severity of CTS. In Moran's study, a cross-sectional area greater than 13 mm was diagnostic for CTS [18]. The current study confirmed those results.…”

Section: Discussion ____________________________supporting

confidence: 87%

High-resolution ultrasonography of cross-sectional area of median nerve compared with electro-diagnostic study in carpal-tunnel syndrome

et al. 2017

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Carpal tunnel syndrome is a common chronic entrapment neuropathy. The present study evaluated the diagnostic ability of ultrasound (US) in measuring the cross-sectional area of the median nerve in the entrance of the carpal tunnel area in comparison with electrodiagnostic testing for diagnosing carpal tunnel syndrome. In this cross-sectional study, 253 patients with carpal tunnel syndrome based on American Academy of Neurology clinical symptoms were selected for participation. After screening, 200 patients were enrolled in the study. Wrist US and electrodiagnostic findings for patients were compared. Data were analyzed by SPSS. There was a good agreement between sonographic and electrodiagnostic findings [right hand (kappa= 0.71), left hand (kappa= 0.78)]. For the right and left hands, respectively, ultrasound sensitivity (89% vs 90%), specificity (90% vs 89.2%), positive predictive value (84.7% vs 94.7%), and negative predictive value (75.7% vs 81.6%) were calculated. High-resolution ultrasound of the median nerve cross-sectional area is an accurate test for diagnosing carpal tunnel with an acceptable level of diagnostic ability. In comparison with the electrodiagnostic test, ultrasonography can provide more practical information about anatomical changes in the tunnel, which can be considered in selecting treatment options.

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Section: Discussion ____________________________supporting

confidence: 87%

High-resolution ultrasonography of cross-sectional area of median nerve compared with electro-diagnostic study in carpal-tunnel syndrome

et al. 2017

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“…Although ultrasound is unable to evaluate proximal etiologies of carpal tunnel-like symptoms, it does have the ability to detect other causes of compression in the carpal tunnel such as space-occupying lesions and tenosynovitis [18,19,26]. Although some studies have confirmed the utility of ultrasound in the diagnosis of CTS, their small sample size and the heterogeneity of study design has made it difficult to draw definitive conclusions regarding the sensitivity and specificity of ultrasonographic measurement of the median nerve in the diagnosis of CTS [17,22,24]. In this meta-analysis, we determined the sensitivity and specificity of ultrasound as a diagnostic tool for CTS.…”

Section: Discussionmentioning

confidence: 99%

The Sensitivity and Specificity of Ultrasound for the Diagnosis of Carpal Tunnel Syndrome: A Meta-analysis

Fowler

Gaughan

Ilyas

2011

Clinical Orthopaedics &Amp; Related Research

269

230

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Background Carpal tunnel syndrome (CTS) is the most commonly diagnosed compression neuropathy of the upper extremity. Current AAOS recommendations are to obtain a confirmatory electrodiagnostic test in patients for whom surgery is being considered. Ultrasound has emerged as an alternative confirmatory test for CTS; however, its potential role is limited by lack of adequate data for sensitivity and specificity relative to electrodiagnostic testing. Questions/purposes In this meta-analysis we determined the sensitivity and specificity of ultrasound in the diagnosis of CTS. Methods A PubMed/MEDLINE search identified 323 articles for review. After applying exclusion criteria, 19 articles with a total sample size of 3131 wrists were included for meta-analysis. Three groups were created: a composite of all studies, studies using clinical diagnosis as the reference standard, and studies using electrodiagnostic testing as the reference standard. Results The composite sensitivity and specificity of ultrasound for the diagnosis of CTS, using all studies, were 77.6% (95% CI 71.6-83.6%) and 86.8% (95% CI 78.9-94.8%), respectively. Conclusions The wide variations of sensitivities and specificities reported in the literature have prevented meaningful analysis of ultrasound as either a screening or confirmatory tool in the diagnosis of CTS. The sensitivity and specificity of ultrasound in the diagnosis of CTS are 77.6% and 86.8%, respectively. Although ultrasound may not replace electrodiagnostic testing as the most sensitive and specific test for the diagnosis of CTS given the values reported in this meta-analysis, it may be a feasible alternative to electrodiagnostic testing as the first-line confirmatory test.

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“…This difference may be due to difference in the sample size, study design and patient's characteristics. In most previous studies, concordance of NCS and ultrasound findings in defining the severity of CTS has been reported (De Krom et al, 2009;Mohammadi et al, 2010;Moran et al, 2009;Pazzaglia and Padua, 2010).…”

Section: Discussionmentioning

confidence: 55%

Diagnostic Accuracy of Ultrasound Findings in Patients with Carpal Tunnel Syndrome

Dehdashti¹,

Kashipazha²,

Rahim³

et al. 2015

J. of Medical Sciences

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Carpal Tunnel Syndrome (CTS) is a common problem that is caused by pressure on a nerve in the wrist and is associated with various factors. We compared Cross-Sectional Area (CSA) of the inlet and outlet in CTS patients and healthy controls and define the best cut off point of CSA and assess the utility of US in the diagnosis of CTS patients as well. This cross-sectional, age-group-matched case-control study was performed on 39 patients aged 42-65 years with electro-physiologically confirmed idiopathic CTS and 35 healthy controls from Golestan Hospital, Ahvaz, Iran from Jan 2013 to Feb 2014. Neurological and electro-diagnostic tests for patients were performed by an expert neurologist as the gold standard diagnostic test for CTS cases. Hundred wrists were evaluated. Electromyography (EMG) showed that 16 (32%) cases were mild, 17 (34%) were moderate and 17 (34%) were severe. The results showed that the CSA of carpal tunnel inlet, carpal tunnel outlet and AP diameter were significantly different between the two groups (p<0.001, p = 0.009, respectively). The sensitivity and specificity of carpal tunnel inlet were 92 and 96%, for carpal tunnel outlet were 92 and 92%, for AP diameter were 64 and 58%. longitudinal evaluations are necessary to better know the utility of ultrasound for diagnosing CTS. The accuracy of diagnosis increases in parallel with the increase in the stages and severity of CTS. Therefore, patients with severe CTS would not need the more uncomfortable, costly and invasive techniques.

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Sonographic measurement of cross‐sectional area of the median nerve in the diagnosis of carpal tunnel syndrome: Correlation with nerve conduction studies

Abstract: Sonographic measurement of median nerve CSA at the tunnel inlet is a good alternative to NC studies as the initial diagnostic test for CTS, but it cannot grade the severity of CTS as well as NC studies.

Cited by 122 publications

References 21 publications

High-resolution ultrasonography of cross-sectional area of median nerve compared with electro-diagnostic study in carpal-tunnel syndrome

High-resolution ultrasonography of cross-sectional area of median nerve compared with electro-diagnostic study in carpal-tunnel syndrome

The Sensitivity and Specificity of Ultrasound for the Diagnosis of Carpal Tunnel Syndrome: A Meta-analysis

Diagnostic Accuracy of Ultrasound Findings in Patients with Carpal Tunnel Syndrome

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