Sonography in the diagnosis of carpal tunnel syndrome: A critical review of the literature

Beekman, Roy; Visser, Leo H.

doi:10.1002/mus.10227

Cited by 276 publications

(244 citation statements)

References 38 publications

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“…Recently, sonography has been evaluated for the evaluation of patients with CTS, 3,11,[16][17][18][19]21,25,28,31,32,34,35,37) and may be a useful alternative to the nerve conduction study, 7,11,20,21,23,31,34,38) with high sensitivity and specificity. 3,11,25,31,32,34,37) Most studies used nerve conduction as the gold standard.…”

Section: Introductionmentioning

confidence: 99%

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Use of Sonography in Carpal Tunnel Syndrome Surgery-A Prospective Study-

Çolak

Kutlay

Pekkafalı

et al. 2007

Neurol. Med. Chir.(Tokyo)

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The diagnosis of carpal tunnel syndrome (CTS) is mainly based on the characteristic symptoms and confirmed with nerve conduction studies. Sonography can provide measurements of the increased cross-sectional area of median nerve. The use of sonography was evaluated for the diagnosis and postoperative follow up of 48 wrists in 26 consecutive patients with CTS. Clinical evaluation and sonography were effective for the diagnosis in 40 wrists. Nerve conduction studies were needed in eight wrists, because of the decrease in cross-sectional area of the nerve as a result of degenerative changes. After 3 months, sonography detected statistically significant decreases in the cross-sectional areas of the median nerves. The sonographic studies were well tolerated by all patients. Sonography was both time-saving and cost-effective.

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Section: Introductionmentioning

confidence: 99%

“…3,11,25,31,32,34,37) Most studies used nerve conduction as the gold standard. A few surgical studies also utilized sonography to identify CTS.…”

Section: Introductionmentioning

confidence: 99%

Use of Sonography in Carpal Tunnel Syndrome Surgery-A Prospective Study-

Çolak

Kutlay

Pekkafalı

et al. 2007

Neurol. Med. Chir.(Tokyo)

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“…Ultrasound has been proposed as an alternative test for the diagnosis of CTS as a result of its potential cost savings, time savings, and improved patient satisfaction resulting from less discomfort [3,7]. Sensitivity and specificity of ultrasound, when using clinical diagnosis as the gold standard (77.3% and 92.8%, respectively), were comparable to the sensitivity and specificity of EDX (69% and 97%, respectively) [9,11].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound as a First-line Test in the Diagnosis of Carpal Tunnel Syndrome: A Cost-effectiveness Analysis

Fowler

Maltenfort

Ilyas

2013

Clinical Orthopaedics &Amp; Related Research

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Background The American Academy of Orthopaedic Surgeons (AAOS) recommends that surgeons obtain a confirmatory test in patients for whom carpal tunnel surgery is being considered. The AAOS, however, does not specify a preferred test. Ultrasound reportedly causes less patient discomfort and takes less time to perform, while maintaining comparable sensitivity and specificity to electrodiagnostic testing (EDX). Questions/purposes We determined whether ultrasound as a first-line diagnostic test is more cost-effective than using EDX alone or using ultrasound alone: (1) when used by a general practitioner; and (2) when used by a specialist. Methods A fictional population of patients was created and each patient was randomly assigned a probability of having true-positive, false-positive, true-negative, and truepositive ultrasound and EDX tests over an expected range of sensitivity and specificity values using Monte Carlo methods. Charges were assigned based on Medicare charges for diagnostic tests and estimates of missed time from work. Results The average charge for the use of ultrasound as a first-line diagnostic test followed by EDX for confirmation of a negative ultrasound test was $562.90 per patient in the general practitioner scenario and $369.50 per patient in the specialist scenario, compared with $400.30 and $428.30 for EDX alone, respectively. Conclusions The use of diagnostic ultrasound as a firstline test for confirmation of a clinical diagnosis of carpal tunnel syndrome is a more cost-effective strategy in the specialist population and results in improved false-negative rates in the generalist population despite increased cost. Level of Evidence Level III, economic and decision analyses. See the Guidelines for Authors for a complete description of levels of evidence.

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“…US'nin KTS tanısındaki duyarlılığı %82-94, özgüllüğü %65-97'dir (27)(28)(29). Santral frekans aralığı 7-10 MHz olan yüzeyel problar ile median sinirde intranöral ödeme bağlı ekojenite kaybı, os hamatumun çengeli seviyesinde yassılaşma, psiform kemik seviyesinde kalınlaşma, PKD'de DRD'e oranla daha belirgin şişme ve fleksor retinakulumda palmar yaylanma gibi bulgular tanımlan-mıştır (17,18,(27)(28)(29)(30). Çok sayıda çalışmada PKD'de median sinirde alan artışı en çok saptanan bulgu olmuştur (30).…”

Section: Gereç Ve Yöntemunclassified

Troid fonksiyon bozukluğu bulunan hastalarda karpal tünel sendromu: Ultrasonografik ve elektrofizyolojik değerlendirme

Uğur¹,

Demirpolat²,

Tuncel³

et al. 2014

Ege Tıp Dergisi

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Amaç: Tiroid fonksiyon bozukluğu bulunan hastalarda karpal tünel sendromunun (KTS), ultrasonografi (US) ve elektrofizyolojik testler ile değerlendirilmesi ve bu hastalarda KTS prevalansının araştırılması. Gereç ve Yöntem:Tiroid fonksiyon bozukluğu (23 hipotiroidi, 17 hipertiroidi) olan 40 hastada 78 el bileği yüksek çözünürlüklü US ve elektrofizyolojik testler ile değerlendirildi. Yirmi bir sağlıklı gönüllüde 41 el bileği kontrol grubunu oluşturdu. US'de median sinirin ekojenitesi değerlendirildi ve distal radial düzey (DRD) ve proksimal karpal kemikler (psiform kemik) düzeyinde (PKD) kesitsel alanı ölçüldü. Median sinir alanının 10 mm2 ve üstünde olması KTS ile uyumlu olarak değerlendirildi. US ve elektrofizyolojik testler ile KTS prevalansı hesaplandı. Bulgular:Kontrol grubunda KTS tanısı alan olgu olmadı. US'de DRD ve/veya PKD deki alan ölçümlerinden birine göre, tiroid disfonksiyonlu 6 hastada 8 el bileğine KTS tanısı koyuldu. Bu hastalarda median sinir alanı DRD'de sağda ve solda sırasıyla 11,00 (± 1,82) mm2 ve 9,75 (± 0,96) mm2, PKD'de 13,00 (± 2,45) mm2 ve 12,25 (± ,63) mm2 ölçüldü. KTS'li tüm olgularda median sinirin daha homojen ve hafif hipoekojen izlendiği dikkati çekti. KTS prevalansı US ve elektrofizyolojik testler ile sırasıyla hipotiroidide % 21,7 ve % 17,3; hipertiroidide % 5,9 bulundu. Sonuç: KTS'li olgularda US incelemede median sinirde ekojenite kaybı ve alan artışı saptanabilir. Hipotiroidi KTS için önemli bir risk faktörüdür. US, risk gruplarının taranmasında kullanılabilir.Anahtar Sözcükler: Troid, karpal tünel sendromu, ultrasonografi, elektrofizyolojik test. Summary Aim: Our objective was to evaluate the patients with thyroid dysfunction for carpal tunnel syndrome (CTS) with ultrasonography (US) and electrophysiologic tests and to investigate the prevalance of CTS in these patients. Materials and Methods: Seventy eight wrists in 40 patients with thyroid dysfunction (23 hypothyroid, 17 hyperthyroid) underwent US and electrodiagnostic tests. Fourty one wrists in 21 healthy volunteers constituted the control group. The echogenicity of the median nerve was evaluated and the cross-sectional area was measured at the level of distal radius (DRL) and the proximal carpal (os pisiforme) bones (PCL

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Sonography in the diagnosis of carpal tunnel syndrome: A critical review of the literature

Cited by 276 publications

References 38 publications

Use of Sonography in Carpal Tunnel Syndrome Surgery-A Prospective Study-

Use of Sonography in Carpal Tunnel Syndrome Surgery-A Prospective Study-

Ultrasound as a First-line Test in the Diagnosis of Carpal Tunnel Syndrome: A Cost-effectiveness Analysis

Troid fonksiyon bozukluğu bulunan hastalarda karpal tünel sendromu: Ultrasonografik ve elektrofizyolojik değerlendirme

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