Anthropometric Measurements as a Screening Test for Carpal Tunnel Syndrome: Receiver Operating Characteristic Curves and Accuracy

Abstract

Objective. To identify optimal cutoff values for body, hand, and wrist measurements in order to correctly identify individuals with carpal tunnel syndrome (CTS), using receiver operating characteristic (ROC) curves. Methods. We enrolled patients with CTS and control subjects at a 1:2 ratio, regardless of age and sex. The diagnosis of CTS was based on clinical findings and delayed distal conduction velocity of the median nerve. The anthropometric measurements included weight, height, waist circumference, hip circumferences, wrist depth/width, third digit length, and palm length/width. Obesity indicators and hand/wrist ratios were calculated. Area under the ROC curve (AUC), sensitivity, specificity, and likelihood ratios were calculated separately according to sex. To assess the role of multiple anthropometric measurements, we fit multivariable logistic regression models including age, wrist ratio, shape index, body mass index, and waist-to-hip ratio. Results. The study group comprised 1,117 subjects (250 female patients and 474 female controls; 120 male patients and 273 male controls). In women, the accuracy of all anthropometric measures was low (AUC £0.64). In men, the accuracy of the hand ratio, shape index, and wrist-to-palm ratio was moderate (AUC 5 0.75). The estimates from the multivariable models confirmed the well-known associations between the selected variables and the risk of CTS, but the use of multiple predictors did not dramatically improve the diagnostic performance observed for single anthropometric indexes. Conclusion. In clinical practice, the cutoff values for many anthropometric measurements have limited value as tools for the diagnosis of CTS.

Association Between Cardiovascular Risk Factors and Carpal Tunnel Syndrome in Pooled Occupational Cohorts

“…Support is found in the literature investigating body shape that appears to be a risk factor with waist circumference having been shown to have a stronger correlation with CTS than hip circumference in men, and both waist-to-hip ratio and body mass index (BMI) have overall comparable associations with CTS. 35 A case-control study found waist circumference and waist-to-hip ratio as independent risks that amplify risk above that from BMI alone. 27 Waist circumference was also identified as an independent risk in another study that also found a relationship with electrodiagnostic severity of CTS.…”

Hand anthropometry in patients with carpal tunnel syndrome: a case-control study with a matched control group of healthy volunteers

“…They examined only women and revealed that females with CTS had a smaller average body height as well as a higher BMI than the control group. Moreover, Mondelli et al [25] have shown that in clinical practice, the cut-off values for many anthropometric measurements have limited value as tools for the diagnosis of CTS. We haven't noticed any significant differences between the CTS patients and control individuals in the lengths and functional lengths of digits as well as total hand length and palm length without fingers.…”

Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel Syndrome

“…33,41 Direct measurements, performed at the time of the electrodiagnostic study, included height, weight, waist and hip circumference, width and depth of the wrist, length of the palm, length of the third digit and of the hand, and width of the palm. In patients with bilateral symptoms, the hand with the worst symptoms was measured or, if there was no difference between sides, the dominant hand was chosen.…”