The role of diagnostic ultrasound in the examination of carpal tunnel syndrome: an update and systematic review

Erickson, Mia; Lawrence, Marsha; Lucado, Ann M.

doi:10.1016/j.jht.2021.04.014

Cited by 30 publications

(17 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…11 CTS usually begins at the age of 20-60 y, the prevalence increasing comparably with the age. 12 Overall, the frequency of CTS is higher in the age range of 25-34 y (89.2%). The high prevalence rate incurs high costs on medical treatment, rehabilitation, lost working hours, initial pension costs, and for new workers training.…”

Section: Introductionmentioning

confidence: 89%

“…USG can also be used to evaluate median nerve and carpal tunnel dimensions, median nerve location within the tunnel (palmar shifting), and flexor retinacular (volar) bowing and thickness. 12 Magnetic resonance imaging (MRI) is an alternative diagnostic tool for CTS. A study conducted in 2002 using NCS and diagram of hand pain as the gold standard showed that MRI gives a sensitivity of 96% for the CTS detection, but only 33% for specificity.…”

Section: Supporting Examinationmentioning

confidence: 99%

See 1 more Smart Citation

Current diagnosis and management of carpal tunnel syndrome: A review

Hidayati¹,

Subadi²,

Fidiana³

et al. 2022

Anaesth. pain intensive care

View full text Add to dashboard Cite

Carpal tunnel syndrome (CTS) is a condition when median nerve, located in the carpal tunnel, is being suppressed by the surrounding structure. In 1854, the first clinical narration of median nerve compression in a carpal tunnel was found. CTS causes pain, tingling, and weakness in the half ring finger, middle finger, index finger, and thumb. These complaints lead the patients to seek medical help by a visiting doctor. CTS has become the major cause of upper extremity chronic neuropathic pain. CTS affects women 3.6 times more than men. This would cause high costs in medical treatment, rehabilitation, work hours lost compensation, initial pension costs, and new worker training. This makes CTS as a major problem in the field of employment. Carpal tunnel syndrome occurs as a result of chronic repetitive forceful work and other risk factors such as sex, age, heredity, hormonal, and weight. Knowledge of the diagnosis and comprehensive management of CTS are important to the doctor. Recent management based on the newest guidelines are important for clinician knowledge update. Correct diagnosis will lead to appropriate management based on recent CTS guidelines, which in turn will improve the quality of life for patients with CTS. This article will comprehensively discuss the diagnosis and recent management. Abbreviations: CTS - Carpal tunnel syndrome; NHIS - National Health Interview Study; EDX - Electrodiagnostic studies; SCT - Scratch Collapse Test; CSA - Cross-sectional area; PRP - Platelet-rich plasma; LLLT - Low-Level Laser Therapy; US – Ultrasound; DN - Dry needling; ECTR - Endoscopic carpal tunnel release; PDI - perineural dextrose injection; BCTQ - Boston Carpal Tunnel Questionnaire Key word: Carpal tunnel syndrome (CTS); neuropathy; pain; numbness; safe working environment; human; disease Citation: Hidayati HB, Subadi I, Fidiana, Puspamaniar VA. Current diagnosis and management of carpal tunnel syndrome: A review. Anaesth. pain intensive care 2022;26(3):394-404. DOI: 10.35975/apic.v26i3.1902 Received: August 16, 2021; Reviewed: April 24, 2022; Accepted: April 28, 2022

show abstract

Section: Introductionmentioning

confidence: 89%

Section: Supporting Examinationmentioning

confidence: 99%

Current diagnosis and management of carpal tunnel syndrome: A review

Hidayati¹,

Subadi²,

Fidiana³

et al. 2022

Anaesth. pain intensive care

View full text Add to dashboard Cite

show abstract

“…However, it is sometimes limited in defining a specific cause (structural vs nonstructural) or in characterizing an anatomic lesion [6,7]. Ultrasound is helpful in the diagnosis of superficial PN, but its accuracy is known to depend on the experience of the sonographer [8].…”

Section: Introductionmentioning

confidence: 99%

Neuropathy Score Reporting and Data System: A Reporting Guideline for MRI of Peripheral Neuropathy With a Multicenter Validation Study

Chhabra

Deshmukh

Lutz

et al. 2022

American Journal of Roentgenology

View full text Add to dashboard Cite

The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

show abstract

“…On the other hand, US can provide information about anatomically and structurally concurrent conditions related to CTS [ 2 ], but it is not widely recommended for routine use [ 3 ]. Nevertheless, robust evidence suggests that US can accurately describe MN neuropathy, but there is not a complete consensus on the optimal US measurements in CTS and its normative values [ 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is little consensus on normative values of MN-CSA because of its dependency on anthropometric parameters (overall wrist circumference and height). Consequently, there is a surprisingly high variability of diagnostic cut-off (varying between 8.5 mm and 15 mm) [ 2 , 4 , 5 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

A Novel Ultrasonographic Anthropometric-Independent Measurement of Median Nerve Swelling in Carpal Tunnel Syndrome: The “Nerve/Tendon Ratio” (NTR)

et al. 2022

View full text Add to dashboard Cite

Background: There is little consensus on ultrasound (US) normative values of cross-sectional area of median nerve (MN-CSA) in carpal tunnel syndrome (CTS) because of its dependency on anthropometric parameters. We aim to propose a novel anthropometric-independent US parameter: MN-CSA/flexor radialis carpi CSA (FCR-CSA) ratio (“Nerve Tendon Ratio”, NTR), in the diagnosis of clinically and electrodiagnostic (EDS)-defined CTS. Methods: 74 wrists of 49 patients with clinically defined CTS underwent EDS (scored by the 1–5 Padua Scale of electrophysiological severity, PS) and US of carpal tunnel with measurement of MN-CSA (at the carpal tunnel inlet), FCR-CSA (over scaphoid tubercle) and its ratio (NTR, expressed as a percentage). US normality values and intra-operator agreement were assessed in 33 healthy volunteers. Results: In controls, the mean MN-CSA was 5.81 mm2, NTR 64.2%. In 74 clinical CTS, the mean MN-CSA was 12.1 mm2, NTR 117%. In severe CTS (PS > 3), the mean MN-CSA was 15.9 mm2, NTR 148%. In CTS, both MN-CSA and NTR correlated with sensitive conduction velocity (SCV) (p < 0.001), distal motor latency (DML) (p < 0.001) and PS (p < 0.001), with a slight superiority of NTR vs. MN-CSA when controlled for height, wrist circumference and weight. In CTS filtered for anthropometric extremes, only NTR maintained a correlation with SCV (p = 0.023), DML (p = 0.016) and PS (p = 0.009). Diagnostic cut-offs were obtained with a binomial regression analysis. In those patients with a clinical diagnosis of CTS, the cut-off of MN-CSA (AUROC: 0.983) was 8 mm2 (9 mm2 with highest positive predictive value, PPV), while for NTR (AUROC: 0.987), the cut-off was 83% (100% with highest PPV). In patients with EDS findings of severe CTS (PS > 3), the MN-CSA (AUROC: 0.876) cut-off was 12.3 mm2 (15.3 mm2 with highest PPV), while for NTR (AUROC: 0.858) it was 116.2% (146.0% with highest PPV). Conclusions: NTR can be simply and quickly calculated, and it can be used in anthropometric extremes.

show abstract

The role of diagnostic ultrasound in the examination of carpal tunnel syndrome: an update and systematic review

Cited by 30 publications

References 34 publications

Current diagnosis and management of carpal tunnel syndrome: A review

Current diagnosis and management of carpal tunnel syndrome: A review

Neuropathy Score Reporting and Data System: A Reporting Guideline for MRI of Peripheral Neuropathy With a Multicenter Validation Study

A Novel Ultrasonographic Anthropometric-Independent Measurement of Median Nerve Swelling in Carpal Tunnel Syndrome: The “Nerve/Tendon Ratio” (NTR)

Contact Info

Product

Resources

About