Role of ultrasonography in patients with mild and moderate carpal tunnel syndrome
Role of ultrasonography in patients with mild and moderate carpal tunnel syndrome
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DOI:
https://doi.org/10.5152/eurjther.2017.04047Keywords:
Carpal tunnel syndrome, ultrasonography, electromyographyAbstract
Objective: This study aimed to determine the diagnostic value of median nerve cross-sectional area (MNCSA; mm2), which can be measured using ultrasonography (US), compared with electrophysiological parameters in patients with mild and moderate carpal tunnel syndrome (CTS).
Methods: The study included 72 wrists of 25 patients with CTS diagnosis and 23 healthy controls. Median and ulnar sensory and motor nerve conduction study results and MNCSA values determined by US, of all subjects were recorded. Electrophysiological and US data of the patient and control groups were compared, and a correlation between MNCSA and velocity and latency of sensory and motor conduction of median nerves was investigated. Moreover, Receiver operating characteristic ROC curve analysis was performed to determine the cut-off value for diagnosing CTS with MNCSA. Differences between the mean MNCSA values, median nerve sensory conduction velocity (SCV), and motor distal latency (MDL) were statistically significant between the groups.
Results: Differences between the mean MNCSA values of grade 1 CTS patients with very mild CTS and those of the healthy controls were statistically significant. There was a moderate and significant negative correlation between MNCSA and SCV values and a low and significant positive correlation between MNCSA and MDL values. In addition, there was a moderate and significant positive correlation between MNCSA values and grades. A cut-off value of 10.25 mm2, which was obtained by the ROC analysis, enabled the differentiation of patients and controls with a sensitivity of 80% and specificity of 76%.
Conclusion: We suggest that MNCSA, which is calculated using US, has high sensitivity and specificity values and is used as a firstline diagnostic tool with electromyography.
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References
Duymuş M, Ulaşlı AM, Yılmaz Ö. Measurement of median nerve cross sectional area with ultrasound and MRI in idiopathic carpal tunnel syndrome patients. J Neurol Sci-Turk 2013; 30: 59-71.
Aylanç N, Temizöz O, Balcı K. Ultrasonographic evaluation of median and ulnar nerves in patients with carpal tunnel syndrome. Ajcı 2015; 9: 103-11.
McDonagh C, Alexander M, Kane D. The role of ultrasound in the diagnosis and management of carpal tunnel syndrome: a new paradigm. Rheumatology 2014; 273-84.
Yesildag A, Kutluhan S, Sengul N, Koyuncuoglu HR, Oyar O, Guler K, et al. The role of ultrasonographic measurements of the median nerve in the diagnosis of carpal tunnel syndrome. Clin Radiol 2004; 59: 910-5.
Koyuncuoglu HR, Kutluhan S, Yesildag A, Oyar O, Guler K, Ozden A. The value of ultrasonographic measurement in carpal tunnel syndrome in patients with negative electrodiagnostic tests. Eur J Radiol 2005; 56: 365-9.
Sirik M, Gulek B, Soker G, Kaya O, Esen K, Yarar Y, et al. The efficacy of 0.2 T low-field open MR imaging in the diagnosis of carpal tunnel syndrome. Glob Adv Res J Med and Medical Sci (GARJMMS) 2014; 3: 008-017.
Bulut HT, Yildirim A, Ekmekci B, Gunbey HP. The diagnostic and grading value of diffusion tensor imaging in patients with carpal tunnel syndrome. Acad Radiol 2014; 21: 767-73.
Yildirim A, Bulut HT, Ekmekci B, Surucu GD, Karabiber M. Use of diffusion tensor imaging for nonsurgical treatments of carpal tunnel syndrome. Muscle Nerve 2014; 50: 950-5.
Bland JD. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve 2000; 23: 1280-3.
Duncan I, Sullivan P, Lomas F. Sonography in the diagnosis of carpal tunnel syndrome. AJR Am J Roentgenol 1999; 173: 681-4.
Fowler JR, Maltenfort MG, Ilyas AM. Ultrasound as a first-line test in the diagnosis of carpal tunnel syndrome: a cost-effectiveness analysis. Clin Orthop Relat Res 2013; 471: 932-937.
Karadağ YS, Karadağ O, Ciçekli E, Oztürk S, Kiraz S, Ozbakir S, et al. Severity of carpal tunnel syndrome assessed with high frequency ultrasonography. Rheumatol Int 2010; 30: 761-5.
Pazzaglia C, Padua L. Severity of carpal tunnel syndrome assessed with high frequency ultrasonography: reply to Karadağ and colleagues. Rheumatol Int 2011; 31: 133-4.
El Miedany YM, Aty SA, Ashour S. Ultrasonography versus nerve conduction study in patients with carpal tunnel syndrome: substantive or complementary tests?. Rheumatology (Oxford)2004; 43: 887-95.
Ziswiler HR, Reichenbach S, Vogelin E, Bachmann LM, Villiger PM, Juni P. Diagnostic value of sonography in patients with suspected carpal tunnel syndrome: a prospective study. Arthritis Rheum 2005; 52: 304-11.
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