Sensitivity of high-resolution ultrasonography in clinically diagnosed carpal tunnel syndrome patients with hand pain and normal nerve conduction studies

Roghani, Reza Salman; Holisaz, M T; Norouzi, Ali Asghar Sahami; Delbari, Ahmad; Gohari, Faeze; Lökk, Johan; Boon, Andrea J.

doi:10.2147/jpr.s164004

Cited by 14 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Visser et al [23] and Wong et al [24] showed that the accuracy of sonography in patients with a clinical diagnosis of CTS is similar to that of EMG. Salman Roghani et al [25] highlighted the complementary role of ultrasonography in diagnosing CTS in conjunction with NCV in patients with clinical CTS and negative NCV. Some authors indicated that sonography is a preferable alternative to EMG/NCV for diagnosing neuropathy of the median nerve and CTS in patients [10,23,24,[26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

et al. 2019

View full text Add to dashboard Cite

Diabetes mellitus (DM) is a common metabolic disease associated with carpal tunnel syndrome (CTS) and tendinopathy. This study aimed to assess the ultrasonographic (US) parameters of the flexor tendon and median nerve in asymptomatic subjects with diabetes in comparison with controls without diabetes. In this study, 22 DM and 22 non-DM subjects with no symptoms or manipulations in non-dominant hands and wrists were assessed. Ultrasound evaluations of the length, width, cross-sectional area, and circumference of the fourth flexor tendon and the median nerve were performed in the two groups. There was no statistically significant difference in age (P value= 0.473), gender (P value= 0.364), or wrist circumference (P value= 0.1921) between the groups. This study showed no significant difference between the two groups in median nerve length (P value= 0.35), width (P value= 0.17), cross-sectional circumference (P value= 0.23), or cross-sectional area (P value= 0.16). Also, a comparison of the sonographic data of the fourth flexor tendon between the two groups presented no significant difference in length (P value = 0.68), width (P value= 0.80), cross-sectional circumference (P value= 0.70), or cross-sectional area (P value= 0.80). In conclusion, data from the present study showed that sonographic values of the median nerve and fourth flexor tendon in asymptomatic subjects with DM did not differ significantly with those of non-diabetics. These findings demonstrate that still more case studies and more evaluations are required to validate the applicability of ultrasonography in the prediction of carpal tunnel syndrome and tendinopathy in diabetic patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

et al. 2019

View full text Add to dashboard Cite

show abstract

“… 31 However, we did not find any correlation between BMI and median CSA in the control group as our previous work. 48 …”

Section: Discussionmentioning

confidence: 99%

“…In contrast, we reported in our previous work that NCV has 27% false negative in our laboratory to detect CTS in clinically confirmed CTS patients. 48 The correlation between age and clinical manifestation of CTS has not been established. A study showed a positive correlation between age and limitation of hand function but not between the age and the severity of symptoms.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment

Roghani¹,

Hashemi²,

Holisaz³

et al. 2018

CIA

Self Cite

View full text Add to dashboard Cite

BackgroundAccurate diagnosis of carpal tunnel syndrome (CTS), the most common entrapment neuropathy, and its differentiation from other diseases are essential, especially in older individuals with advanced symptoms and modified electrophysiological abnormalities. The current study was conducted to evaluate the diagnostic accuracy of ultrasonography (US), regarding sensitivity and specificity in the diagnosis of CTS in elderly patients.MethodsIndividuals with upper limb complaints and reference subjects were recruited from the Rofaydeh Hospital, Tehran, Iran, from June 2013 to October 2014 – (15 months). We evaluate case and control subjects for health status, demographics, clinical characteristics of CTS, median nerve physiology by electrodiagnostic tests, and anatomy by US. Median nerve cross-sectional area (CSA) at precanal, tunnel inlet, midcanal, tunnel outlet, and antecubital levels was measured applying US examination.ResultsOf the 723 complaining patients, we assessed 380 patients with CTS symptoms. Electrodiagnostic studies (EDX) confirmed the CTS diagnosis in 203 of these clinically diseased patients. A total of 103 patients (of the 113 reference subjects) had normal EDX in the reference group. Comparisons of wrists between the afflicted and reference subjects demonstrated the CSA at precanal, tunnel inlet, midcanal, and tunnel outlet levels being significantly more abundant in the diseased hands than in the nondiseased hands. CSA at the tunnel inlet and the inlet-to-antecubital CSA ratio with a threshold of 8.5 mm2 and 0.65 gave the best diagnostic accuracy with a sensitivity and specificity of 96.9 and 93.6% for the inlet CSA and 99 and 28% for the CSA ratio, respectively.ConclusionThe US as a noninvasive diagnostic method may serve for the investigation of CTS in elderly patients with excellent sensitivity and specificity.

show abstract

“…This finding is central to one of the most important, evidence-supported values of NMUS in the EDX laboratory. In patients with symptoms of CTS but normal EDX studies, 27%–73% of patients will have an enlarged median nerve on NMUS according to cutoff values that generate few false positives (0%–7.5%) in control populations from the same studies 17–21 . Although it cannot be determined with certainty that these patients, in fact, have CTS, their results are unlikely to be a false positive, and EDX has found no other cause for the symptoms in these patients.…”

Section: Specific Conditionsmentioning

confidence: 99%

Neuromuscular Ultrasound

Jorgensen

Cartwright

Norbury

2021

Am J Phys Med Rehabil

View full text Add to dashboard Cite

Accurate assessment of neuromuscular disorders is critical to facilitate timely treatment and achieve the best outcomes. Historically, electrodiagnostic studies have filled this role, but recently, neuromuscular ultrasound is being used in the electrodiagnostic laboratory. This review discusses the uses of neuromuscular ultrasound in the electrodiagnostic laboratory that have strong evidence, emphasizing those that could be adopted in a typical electrodiagnostic laboratory with a reasonable level of equipment and training. The evidence currently supports using neuromuscular ultrasound to diagnose carpal tunnel syndrome and ulnar neuropathies at the elbow and as a supplementary test when electrodiagnostic studies are suspected to be falsely negative or in axonal nonlocalizing lesions. Neuromuscular ultrasound can identify the causes of focal mononeuropathies, which can change treatment in specific cases. It is sensitive at identifying fasciculations and providing complementary evidence of autoimmune demyelinating polyneuropathies. It is particularly helpful in assessing nerves after trauma. Neuromuscular ultrasound is likely to prove even more useful in the electrodiagnostic laboratory as the technology continues to advance.

show abstract

Sensitivity of high-resolution ultrasonography in clinically diagnosed carpal tunnel syndrome patients with hand pain and normal nerve conduction studies

Cited by 14 publications

References 25 publications

Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

Comparison of Sonographic Evaluation of the Median Nerve and Fourth Flexor Tendon Between Asymptomatic Subjects With and Without Diabetes

The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment

Neuromuscular Ultrasound

Contact Info

Product

Resources

About