Submitted by: Elliot Bodofsky, MD
Reviewed by: Shan Chen, MD
Ciloglu O, Gorgulu F. Which ultrasound parameter is more accurate in the diagnosis of carpal tunnel syndrome. American Journal of PM&R.
Ultrasound (US) can be useful to diagnosing carpal tunnel syndrome (CTS). Most US CTS studies have looked at median nerve cross sectional area (CSA). Others use resistive index (RI) or strain ratio (SR) as the criteria. This study compared CSA with RI and SR in CTS. There were 36 hands in 36 patients with CTS symptoms and on NCS, and 50 hands in 25 control patients (no CTS symptoms and normal NCS). All these three ultrasound diagnostic techniques had high sensitivity and specificity (sensitivities 94+ %, specificities 84+ %). Likewise, the 3 criteria were effective in diagnosing severe CTS, but not accurate in differentiating mild and moderate CTS. There was no correlation between length of clinical symptoms and any of these US criteria.
This study indicates that multiple ultrasound criteria can be useful in the diagnosis of CTS as well as determining severe cases.