Use of Multiple Ultrasonographic Parameters in Confirmation of Carpal Tunnel Syndrome

Ažman, Dražen; Hrabač, Pero; Demarin, Vida

doi:10.1002/jum.14417

Cited by 28 publications

(59 citation statements)

References 45 publications

(100 reference statements)

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“…4 Many studies used bilateral observations of single participants, treating each wrist individually in the statistical analysis. 3,5,10,[12][13][14][16][17][18][19] The participant characteristics (age, height, weight, body mass index, and gender ratio) of all 21 studies are summarised in Table 1. Many studies specified the mean age and male-to-female ratio of both case and control groups, with matching of case/controls in 13 studies.…”

Section: Resultsmentioning

confidence: 99%

“…[6][7][8][9][10] Electrodiagnostic testing is considered by authors to be an accurate test, with a sensitivity and specificity of 78-95% and 80-95%, respectively. 1,11,[12][13][14] However, other authors have reported varying false-negative rates of 10-34%. 2,[6][7][8][9] The test assesses for physiological delays within the median nerve through slowed electrical conduction due to compression, representing the degree of inflammation and axon loss.…”

Section: Introductionmentioning

confidence: 99%

“…10,11,15 This enables the detection of CTS with grading of the severity. 11,14 However, EDx requires an invasive approach and an extended examination time, with limited and often cost-prohibitive availability. 2,5,7 Additionally, EDx lacks the ability to diagnose underlying anatomical causes of compressive neuropathy.…”

Section: Introductionmentioning

confidence: 99%

“…Examples include the inlet and outlet cross-sectional area, inlet-outlet ratio, wristto-forearm ratio, and the cross-sectional area difference between the wrist and forearm. 1,3,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition, a flattening ratio and supplementary parameters of colour Doppler Correspondence to email: callumlinehan@hotmail.com doi: 10.1002/ajum.12219 and median nerve mobility are also reported in the literature. 2,4,6,7,11,20 Many studies have compared these ultrasound parameters using differing study designs with varying results.…”

Section: Introductionmentioning

confidence: 99%

“…6,10,17 Consequently, meaningful analysis of the literature is challenging due to differences between study designs, thus increasing the difficulty of determining the diagnostic utility of ultrasound in CTS. 2,14 While not a perfect test, the use of EDx may provide a basis for comparison for the diagnostic utility of ultrasound in CTS.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Ultrasound parameters to identify and diagnose carpal tunnel syndrome. A review of the literature

Linehan

Childs

Quinton

et al. 2020

Australas J Ultrason Med

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Numerous works of literature have assessed the use of ultrasound to detect carpal tunnel syndrome, suggesting various techniques and cut‐off values. Currently, an effective parameter and cut‐off value are still debated. The aim of this review is to determine if these parameters have sufficient rigour to allow their use in clinical practice. Twenty‐one studies using sonographic parameters to identify carpal tunnel syndrome in comparison with electrodiagnostic testing (EDx) were selected for review. Methodological differences were found between studies in the use of EDx criteria, scanning and recruitment protocols, with participant biometrics often not reported. Parameters including the cross‐sectional area of the median nerve at the level of the pisiform bone in addition to the wrist‐to‐forearm difference demonstrated high diagnostic utility for set cut‐off values. Doppler techniques and mobility are promising, and further research is required to understand the effectiveness of these techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ultrasound parameters to identify and diagnose carpal tunnel syndrome. A review of the literature

Linehan

Childs

Quinton

et al. 2020

Australas J Ultrason Med

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show abstract

Assessing Diagnostic and Severity Grading Accuracy of Ultrasound Measurements for Carpal Tunnel Syndrome Compared to Electrodiagnostics

Chen

Olson

Lee

et al. 2021

PM&R

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Background The combined sensory index (CSI) is the most sensitive electrodiagnostic criteria for carpal tunnel syndrome (CTS), and the CSI and Bland criteria have been shown to predict surgical treatment outcomes. The proposed ultrasound measurements have not been assessed against the CSI for diagnostic accuracy and grading of CTS severity. Objective To investigate the use of ultrasound evaluations for both diagnosis and assessment of severity grading of CTS in comparison to electrodiagnostic assessment. Design All patients underwent an electrodiagnostic evaluation using the CSI and Bland severity grading. Each patient underwent an ultrasound evaluation including cross‐sectional area (CSA), the change in CSA from the forearm to the tunnel (∆CSA), and the wrist‐forearm ratio (WFR). These measurements were assessed for diagnostic and severity grading accuracy using the CSI as the gold standard. Setting Tertiary academic center. Participants All patients referred for electrodiagnostic evaluation for CTS were eligible for the study. Only those with idiopathic CTS were included and those with prior CTS treatment were also excluded. Ninety‐five patients were included in the study. Interventions Not applicable. Main Outcome Measures The primary study outcome measure was concordance between CSI diagnosis and severity categories and the ultrasound measurements. Both outcomes were also assessed using Bland criteria. Results Optimal cut‐points for diagnosis of CTS were found to be CSA ≥12 mm2, ∆CSA ≥4 mm2, WFR ≥1.4. Using these cut‐points, C‐statistics comparing diagnosis of CTS using ultrasound measurements versus using the CSI ranged from 0.893‐0.966. When looking at CSI severity grading compared to ∆CSA, however, the C‐statistics were 0.640‐0.661 with substantial overlap between severity groups. Conclusions Although ultrasound measurements had high diagnostic accuracy for CTS based on the CSI criteria, ultrasound measurements were unable to adequately distinguish between CSI severity groups among patients with CTS.

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Evolution of Sports Ultrasound

Smith

Schroeder

Lloyd

et al. 2022

Musculoskeletal Ultrasound-Guided Regenerative Medicine

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Use of Multiple Ultrasonographic Parameters in Confirmation of Carpal Tunnel Syndrome

Abstract: Results of the study show that the mean cross-sectional area and inlet cross-sectional area may be valid and easy-to-acquire parameters for routine clinical use in confirming CTS.

Cited by 28 publications

References 45 publications

Ultrasound parameters to identify and diagnose carpal tunnel syndrome. A review of the literature

Ultrasound parameters to identify and diagnose carpal tunnel syndrome. A review of the literature

Assessing Diagnostic and Severity Grading Accuracy of Ultrasound Measurements for Carpal Tunnel Syndrome Compared to Electrodiagnostics

Evolution of Sports Ultrasound

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