Objectives-To determine the value of grayscale and power Doppler ultrasound (PDUS) in the evaluation of carpal tunnel syndrome (CTS) in clinically suspected patients.Methods-Eighty-seven wrists of 61 patients with clinically suspected CTS and 57 wrists of 30 healthy control participants were included in our study. Median nerve (MN) cross-sectional area (CSA) measurements were performed at the tunnel inlet level (wCSA) and proximal pronator quadratus muscle level (fCSA). Two parameters were calculated: CSA absolute difference (ΔCSA), which was the difference between the two measurements; and CSA ratio (RCSA), calculated by dividing wCSA over fCSA. The MN at the wrist level was evaluated for hypervascularity with PDUS.Results-The mean wCSA, R-CSA, and ΔCSA values were significantly higher in patients (17 mm 2 , 2.45, and 9.9 mm 2 , respectively) than in control participants (8 mm 2 , 1.29, and 1.65 mm 2 ; (P < .0001). At their corresponding cutoff values, the wCSA yielded higher sensitivity (95%) and lower specificity (88%) compared to the RCSA and ΔCSA (89% and 93% sensitivity and 93% and 89% specificity). Power Doppler US was the most specific US parameter (100%) but the least sensitive (76%). A multivariate logistic regression model including the wCSA, RCSA, and PDUS yielded 97% diagnostic accuracy at their optimal cutoffs, which increased to 99% after eliminating age and body mass index confounding effects.Conclusions-The combination of MN swelling measurements and PDUS increases the diagnostic accuracy of US in patients with clinically suspected CTS.

Background Plantar fasciitis due to calcaneal spur is a common cause of heel pain and functional disability, and its management presents a huge challenge for clinicians which results sometimes in unpleasant clinical outcomes. The efficacy of extracorporeal shock wave therapy (ESWT) as an alternative therapeutic option to surgical management after failure of conservative treatment has been addressed. Our aim was to evaluate the efficacy of ESWT in the treatment of plantar fasciitis in calcaneal spur patients using ultrasonography. Results The mean plantar fascia (PF) thickness was statistically significantly higher in the calcaneal spur patient group (5.66 ± 1.14 mm) than in the healthy control group (2.40 ± 0.35 mm), (P = 0.001). Significant PF thickness reduction, visual analog scale (VAS), and Roles and Maudsley score (RMS) improvement were observed (P < 0.001) after 4 sessions of ESWT. Conclusion PF thickness increases significantly in calcaneal spur patients and responds to treatment. ESWT decreases the thickness of the PF and improves pain and function significantly.