Comparison of the Diagnostic Utility of Electromyography, Ultrasonography, Computed Tomography, and Magnetic Resonance Imaging in Idiopathic Carpal Tunnel Syndrome Determined by Clinical Findings

Deniz, Fatih Ersay; Öksüz, Erol; Sarıkaya, Başar; Kurt, Semiha; Erkorkmaz, Ünal; Ulusoy, Hasan; Arslan, Serkan

doi:10.1227/neu.0b013e318233868f

Cited by 53 publications

(28 citation statements)

References 59 publications

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“…The electrophysiological studies usually show the level of the lesion, but do not provide anatomical information about the nerve or its surroundings. In the last few years, ultrasonography (US) has been shown to be useful diagnostic tools in CTS, providing information on the median nerve and surrounding structures4,6,13,23). A few papers have been published in neurosurgery literature regarding diagnostic utility of ultrasonography in carpal tunnel syndrome1,6).…”

Section: Introductionmentioning

confidence: 99%

“…In the last few years, ultrasonography (US) has been shown to be useful diagnostic tools in CTS, providing information on the median nerve and surrounding structures4,6,13,23). A few papers have been published in neurosurgery literature regarding diagnostic utility of ultrasonography in carpal tunnel syndrome1,6). To our knowledge, publication has not been available, describing measurements of ultrasonographic parameters for the diagnosis of CTS, compared with electrodiagnostic findings as well as clinical severity, assessed by historical-objective scale9).…”

Section: Introductionmentioning

confidence: 99%

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Value of Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome: Correlation with Electrophysiological Abnormalities and Clinical Severity

Kim

Jeon

Park

et al. 2014

J Korean Neurosurg Soc

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ObjectiveTo investigate a diagnostic value of ultrasonography in carpal tunnel syndrome (CTS) patients and to evaluate a correlation of sonographic measurements with the degree of electrodiagnostic abnormalities and clinical severity.MethodsTwo-hundred-forty-six symptomatic hands in 135 patients and 30 asymptomatic hands in 19 healthy individuals as control group were included. In ultrasonographic study, we measured the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve at the pisiform as well as palmar bowing (PB) of the flexor retinaculum. Sensitivity and specificity of ultrasonographic measurements were evaluated and ultrasonographic data from the symptomatic and control hands were compared to the grade of electrodiagnostic and clinical severity.ResultsThe mean CSA was 13.7±4.2 mm2 in symptomatic hands and 7.9±1.3 mm2 in asymptomatic hands. The mean FR was 4.2±1.0 in symptomatic hands and 3.4±0.4 in asymptomatic hands. The mean PB was 3.5±0.5 mm in symptomatic hands and 2.6±0.3 mm in asymptomatic hands. Statistical analysis showed differences of the mean CSA, FR and PB between groups were significant. A cut-off value of 10 mm2 for the mean CSA was found to be the upper limit for normal value. Both the mean CSA and PB are correlated with the grade of electrophysiological abnormalities and clinical severity, respectively.ConclusionUltrasographic measurement of the CSA and PB is helpful to diagnose CTS as a non-invasive and an alternative modality for the evaluation of CTS. In addition, ultrasonography also provides a reliable correlation with the grade of electrodiagnostic abnormalities and clinical severity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Value of Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome: Correlation with Electrophysiological Abnormalities and Clinical Severity

Kim

Jeon

Park

et al. 2014

J Korean Neurosurg Soc

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“…Similarly, a study comparing the diagnostic accuracy of EDS, US, CT and MRI in CTS, compared to clinical diagnosis as a reference standard, showed that these four tests had similar accuracy for the diagnosis of CTS. 16 The existing evidence does not support using either EDS or imaging tests over history and physical exam for CTS diagnosis. Furthermore, EDS prior to CTR was associated with prolonged time to surgery, additional out of pocket costs, and greater total costs in a national study.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Testing Requested Before Surgical Evaluation for Carpal Tunnel Syndrome

Sears

Wood

et al. 2017

The Journal of Hand Surgery

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Purpose We sought to evaluate how often physicians who perform carpal tunnel release (CTR) in the State of Michigan routinely request electrodiagnostic studies (EDS) or other diagnostic tests prior to an initial consultation, and whether provider or practice characteristics had an influence on requirements for pre-consultation diagnostic tests. Methods Through online data sources, we identified 356 providers in 261 practices throughout the State of Michigan with profiles confirming hand surgery practice or surgical treatment of carpal tunnel syndrome (CTS). We recorded American Society for Surgery of the Hand (ASSH) membership, teaching facility status, practice size, and primary specialty for each provider. Using a standardized telephone script, 219 providers were contacted by telephone to determine whether any diagnostic tests were needed before an appointment. Using multivariable logistic regression, we evaluated the relationship between the requirement for pre-consultation testing and surgeon and practice characteristics. Results Among the 134 providers who were confirmed to perform CTR, 57% (n=76) required and 9% (n=12) recommended a diagnostic test prior to the initial consultation. Of the 88 physicians who required/recommended testing, 85% (n=75) requested EDS, 22% (n=19) requested an MRI, 13% (n=11) requested a CT scan, and 9% (n=8) requested an X-ray. Patients were asked to have multiple studies by 19 (22%) of the 88 surgeons who requested/recommended testing. In the multivariable analysis, ASSH membership, size of practice and teaching facility status did not have a significant relationship with the requirement for pre-consultation testing. Conclusions Most surgeons who treat CTS in the State of Michigan routinely request EDS before evaluation, rather than reserving the test for cases where the diagnosis is unclear.

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“…Die bildgebenden Verfahren -hochauflösende Neurosonografie, Computertomografie und Kernspintomografie -gewinnen zunehmende Bedeutung bei der Diagnostik des KTS (s. ▶ , sind allerdings noch nicht erste Wahl (Deniz et al 2012). Allenfalls die Sonografie ist ein Konkurrenzverfahren zur Elektrophysiologie und könnte dieser den ersten Platz streitig machen (Fowler et al 2011 (Wu et al 2004).…”

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Comparison of the Diagnostic Utility of Electromyography, Ultrasonography, Computed Tomography, and Magnetic Resonance Imaging in Idiopathic Carpal Tunnel Syndrome Determined by Clinical Findings

Cited by 53 publications

References 59 publications

Value of Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome: Correlation with Electrophysiological Abnormalities and Clinical Severity

Value of Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome: Correlation with Electrophysiological Abnormalities and Clinical Severity

Diagnostic Testing Requested Before Surgical Evaluation for Carpal Tunnel Syndrome

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