Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data
Background: Sonologic evaluation of the median nerve has been shown to be a useful tool in carpal tunnel syndrome diagnosis. Neurosonology supplants clinical and electrodiagnostic work up. Objectives: To determine the median nerve ultrasound parameters in carpal tunnel syndrome (CTS) patien...
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| Format: | Article |
| Language: | English |
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ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES
2022-06-01
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| Series: | Journal of Medical Sciences and Health |
| Online Access: | https://jmsh.ac.in/index.php?option=com_k2&view=item&id=239:nerve-ultrasound-findings-in-carpal-tunnel-syndrome-and-its-correlation-with-clinical-and-electrophysiological-data&Itemid=1 |
| _version_ | 1811291464427110400 |
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| author | Praveen Panicker Thomas Iype |
| author_facet | Praveen Panicker Thomas Iype |
| author_sort | Praveen Panicker |
| collection | DOAJ |
| description | Background: Sonologic evaluation of the median nerve has been shown to be a useful tool in carpal tunnel syndrome diagnosis. Neurosonology supplants clinical and electrodiagnostic work up. Objectives: To determine the median nerve ultrasound parameters in carpal tunnel syndrome (CTS) patients and find their correlation with patient reported clinical data and electrophysiology findings,to assess diagnostic accuracy of nerve ultrasound in CTS in comparison to clinical evaluation combined with electrodiagnosis as reference standard. Methods: 23 consecutive patients with carpal tunnel syndrome symptoms (46 wrists-35 with nerve conduction study confirmed CTS, 11 without CTS) underwent neurosonologic evaluation with high resolution ultrasound including median nerve cross sectional area(CSA) at carpal tunnel inlet, flattening ratio, Wrist/forearm CSA ratio measurements. Patient reported measures were recorded using Boston carpal tunnel syndrome questionnaire (BCTQ). Results: Statistically significant correlation was found between median nerve CSA at carpal tunnel inlet and disease severity assessed by electrodiagnosis (r=0.545, p value-0.002), hand function status had significant correlation with electrodiagnostic severity class (r=0.422, p value 0.012). Flattening ratio, Wrist/forearm CSA ratio did not show significant correlation with clinical and electrophysiology measures. Sensitivity and specificity for a cross sectional area cut off of 9 cm2 for diagnosis of CTS was found to be 85.7 percent and 64 percent respectively. Conclusion: Median nerve cross sectional area CSA measurement is the most useful neurosonologic parameter and correlates with electrodiagnostic severity. Ultrasound is a useful complementary tool for CTS diagnosis, assessment alongside electrodiagnosis. Keywords: Carpal Tunnel Syndrome, Neurosonology, Compression neuropathy |
| first_indexed | 2024-04-13T04:28:47Z |
| format | Article |
| id | doaj.art-9b9d648e2bbb4983bc38b0610fbade2a |
| institution | Directory Open Access Journal |
| issn | 2394-9481 2394-949X |
| language | English |
| last_indexed | 2024-04-13T04:28:47Z |
| publishDate | 2022-06-01 |
| publisher | ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES |
| record_format | Article |
| series | Journal of Medical Sciences and Health |
| spelling | doaj.art-9b9d648e2bbb4983bc38b0610fbade2a2022-12-22T03:02:23ZengADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCESJournal of Medical Sciences and Health2394-94812394-949X2022-06-0181596410.46347/jmsh.v8i1.21.125Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological DataPraveen PanickerThomas Iype Background: Sonologic evaluation of the median nerve has been shown to be a useful tool in carpal tunnel syndrome diagnosis. Neurosonology supplants clinical and electrodiagnostic work up. Objectives: To determine the median nerve ultrasound parameters in carpal tunnel syndrome (CTS) patients and find their correlation with patient reported clinical data and electrophysiology findings,to assess diagnostic accuracy of nerve ultrasound in CTS in comparison to clinical evaluation combined with electrodiagnosis as reference standard. Methods: 23 consecutive patients with carpal tunnel syndrome symptoms (46 wrists-35 with nerve conduction study confirmed CTS, 11 without CTS) underwent neurosonologic evaluation with high resolution ultrasound including median nerve cross sectional area(CSA) at carpal tunnel inlet, flattening ratio, Wrist/forearm CSA ratio measurements. Patient reported measures were recorded using Boston carpal tunnel syndrome questionnaire (BCTQ). Results: Statistically significant correlation was found between median nerve CSA at carpal tunnel inlet and disease severity assessed by electrodiagnosis (r=0.545, p value-0.002), hand function status had significant correlation with electrodiagnostic severity class (r=0.422, p value 0.012). Flattening ratio, Wrist/forearm CSA ratio did not show significant correlation with clinical and electrophysiology measures. Sensitivity and specificity for a cross sectional area cut off of 9 cm2 for diagnosis of CTS was found to be 85.7 percent and 64 percent respectively. Conclusion: Median nerve cross sectional area CSA measurement is the most useful neurosonologic parameter and correlates with electrodiagnostic severity. Ultrasound is a useful complementary tool for CTS diagnosis, assessment alongside electrodiagnosis. Keywords: Carpal Tunnel Syndrome, Neurosonology, Compression neuropathyhttps://jmsh.ac.in/index.php?option=com_k2&view=item&id=239:nerve-ultrasound-findings-in-carpal-tunnel-syndrome-and-its-correlation-with-clinical-and-electrophysiological-data&Itemid=1 |
| spellingShingle | Praveen Panicker Thomas Iype Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data Journal of Medical Sciences and Health |
| title | Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data |
| title_full | Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data |
| title_fullStr | Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data |
| title_full_unstemmed | Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data |
| title_short | Nerve Ultrasound Findings in Carpal Tunnel Syndrome and its Correlation with Clinical and Electrophysiological Data |
| title_sort | nerve ultrasound findings in carpal tunnel syndrome and its correlation with clinical and electrophysiological data |
| url | https://jmsh.ac.in/index.php?option=com_k2&view=item&id=239:nerve-ultrasound-findings-in-carpal-tunnel-syndrome-and-its-correlation-with-clinical-and-electrophysiological-data&Itemid=1 |
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