Ultrasonic Assessment of Females with Carpal Tunnel Syndrome Proved by Nerve Conduction Study

Abstract

Introduction. Carpal tunnel syndrome (CTS) is the most commonly diagnosed entrapment neuropathy of the upper extremity. The objective of this study was to diagnose CTS and to assess its severity using high resolution ultrasound (HRUS) depending on the results of nerve conduction study (NCS). Methods. A prospective cross-sectional study, in which HRUS was performed at 63 wrists of 35 female patients with different severity of CTS (as proved by NCS). Furthermore, 40 healthy volunteers (80 wrists) underwent the same tests as the patients and have been chosen to match the patients in gender, age, and body mass index (BMI). The cross section area (CSA) of the median nerve (MN) was obtained using HRUS at the carpal tunnel inlet by direct tracing method. Results. There was a significant difference in the CSA of the MN at the tunnel inlet in CTS patients when compared with the control group. In fact, the CSA of the control group showed a significant difference from each of patients subgroups. Furthermore, a significant difference in the CSA was seen in between these subgroups. In conclusion, the US examination of the MN seems to be a promising method in diagnosing and grading of carpal tunnel syndrome.

Sonographic cross-sectional area measurement in carpal tunnel syndrome patients: can delta and ratio calculations predict severity compared to nerve conduction studies?

“…Several studies have confirmed the feasibility of distal CSA measurement of the median nerve not only in the diagnosis of CTS, but also in the grading of CTS severity [9,[24][25][26][27], especially when using the ratio measurement [8][9][10]. Fig.…”

Carpal Tunnel Syndrome Grading Using High-Resolution Ultrasonography

“…6 In this study, NCS of the MN were used as a valuable technique for the diagnosis and subdivision of patient group into the following three groups: mild, moderate, and severe CTS. 6 In this study, NCS of the MN were used as a valuable technique for the diagnosis and subdivision of patient group into the following three groups: mild, moderate, and severe CTS.…”

“…3 However, NCS have several limitations because they are uncomfortable for many patients. [6][7][8][9] Several studies have noted that increases in the crosssectional area (CSA) of the median nerve (MN) in the wrist are the most reliable finding in the diagnosis of CTS. 4 By contrast, high-resolution ultrasonography (HRUS) is a quick and painless procedure that sheds light on the anatomy 5 and potentially the etiology of the pathology causing CTS.…”

Comparison of high-resolution sonography and electrophysiology in the diagnosis of carpal tunnel syndrome

“…[ 21 ] US could be used to grade the severity of CTS and to detect space-occupying lesions or anatomical variation of median nerve. [ 17 ] In the present study, it was possible to correlate HRUS findings and EDX findings based on CTS grading. It showed that the accuracy of HRUS was similar to that for EDX in all grades of CTS and CTS + PNP in patients with a clinical diagnosis of CTS.…”

“…There are many studies emphasizing the role of imaging in the diagnosis of CTS. [ 13 14 15 16 17 ] It has been shown that high-resolution ultrasonography (HRUS) is very useful where EDX has been equivocal and in assessment of recurrent or unrelieved symptoms after surgical carpal tunnel release. A reliable diagnosis of CTS could be made sonographically, mainly based on an increase in cross-sectional area (CSA) of the median nerve at the level of the Pisiform or Hamate bone.…”