Comparison of Borderline Ultrasound and Nerve Conduction Studies for Carpal Tunnel Syndrome

Hand ◽  
2020 ◽  
pp. 155894472096496
Author(s):  
Cory Demino ◽  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Threshold Values ◽  
Cutoff Values ◽  
Number Of Patients ◽  
Tunnel Syndrome ◽  
Median Neuropathy

Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

scholarly journals Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

2021 ◽  
Vol 8 (11) ◽  
pp. 181
Author(s):  
Konstantinos I. Tsamis ◽  
Prokopis Kontogiannis ◽  
Ioannis Gourgiotis ◽  
Stefanos Ntabos ◽  
Ioannis Sarmas ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Automatic Detection ◽  
Nerve Conduction Studies ◽  
Machine Learning Techniques ◽  
Tunnel Syndrome

Recent literature has revealed a long discussion about the importance and necessity of nerve conduction studies in carpal tunnel syndrome management. The purpose of this study was to investigate the possibility of automatic detection, based on electrodiagnostic features, for the median nerve mononeuropathy and decision making about carpal tunnel syndrome. The study included 38 volunteers, examined prospectively. The purpose was to investigate the possibility of automatically detecting the median nerve mononeuropathy based on common electrodiagnostic criteria, used in everyday clinical practice, as well as new features selected based on physiology and mathematics. Machine learning techniques were used to combine the examined characteristics for a stable and accurate diagnosis. Automatic electrodiagnosis reached an accuracy of 95% compared to the standard neurophysiological diagnosis of the physicians with nerve conduction studies and 89% compared to the clinical diagnosis. The results show that the automatic detection of carpal tunnel syndrome is possible and can be employed in decision making, excluding human error. It is also shown that the novel features investigated can be used for the detection of the syndrome, complementary to the commonly used ones, increasing the accuracy of the method.

scholarly journals Carpal tunnel syndrome caused by cysticercosis

2010 ◽  
Vol 43 (02) ◽  
pp. 210-212
Author(s):  
S. R. Sharma ◽  
Nalini Sharma ◽  
M. E. Yeolekar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction Studies ◽  
Resonance Imaging ◽  
Inflammatory Mass ◽  
Tunnel Syndrome ◽  
Median Neuropathy

ABSTRACTWe present a case of carpal tunnel syndrome (CTS) due to compression of the median nerve within the carpal tunnel, caused by cysticercosis. Nerve conduction studies revealed severe CTS. Magnetic resonance imaging suggested an inflammatory mass compressing the median nerve in carpal tunnel. The histological diagnosis was consistent with cysticercosis. The case resolved with conservative treatment. Such solitary presentation of entrapment median neuropathy as CTS caused by cysticercosis is extremely rare. To our knowledge, this is the only case of its kind reported in literature till date.

Case 14

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Clinical Practice ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Case Presentation ◽  
Peripheral Polyneuropathy ◽  
Tunnel Syndrome ◽  
Internal Comparison

Carpal tunnel syndrome is the most common entrapment neuropathy encountered in clinical practice. It is also the most common reason for referral to the electromyography laboratory. The anatomy of the median nerve and the carpal tunnel are outlined in details in this case presentation. The recommended nerve conduction studies needed to make a diagnosis are outlined. This includes internal comparison nerve conduction studies in which the median nerve is compared to a neighboring nerve such as ulnar or radial nerves, as well as the inching studies across the carpal tunnel. Finally, special situations are emphasized including severe carpal tunnel syndrome, carpal tunnel syndrome associated with peripheral polyneuropathy, carpal tunnel syndrome in the presence of Martin–Gruber anastomosis, and carpal tunnel syndrome during pregnancy.

P115 Median nerve conduction studies of digit 1 to 4 in carpal tunnel syndrome

2008 ◽  
Vol 119 ◽  
pp. S100
Author(s):  
Akrami Shahram ◽  
Sadighi Gita ◽  
Sadighi Alereza ◽  
Sadigh Mostofi Mohamad Sadegh ◽  
Enami Alamdari Mohamad
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome

scholarly journals Ultrasonographic and electrophysiological outcomes of carpal tunnel syndrome treated with low-level laser therapy: A double-blind, prospective, randomized, sham-controlled study

2021 ◽  
Author(s):  
Merve Nalbant ◽  
Oya Ümit Yemişci ◽  
Selin Özen ◽  
Şehnaz Tezcan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Therapy Group ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Low Level Laser Therapy ◽  
Level Laser ◽  
Tunnel Syndrome

Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4±8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen’s test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.

P111 Nerve conduction studies and sonographic assessment of median nerve in patients with carpal tunnel syndrome

2008 ◽  
Vol 119 ◽  
pp. S99
Author(s):  
Yeşim Sücüllü Karadağ ◽  
Esen Çiçekli ◽  
Ömer Karadağ ◽  
Şerefnur Öztürk ◽  
Sedat Kiraz ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Sonographic Assessment ◽  
Tunnel Syndrome

Effects of Diacutuaneous Fibrolysis on Mechanosensitivity, Disability and Nerve Conduction Studies in Mild to Moderate Carpal Tunnel Syndrome: Secondary Analysis of a Randomized Controlled Trial

2020 ◽  
Author(s):  
Sandra Jiménez del Barrio ◽  
Luis Ceballos Laita ◽  
Elena Bueno Gracia ◽  
Sonia Rodríguez Marco ◽  
María Haddad Garay ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Nerve Conduction ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome

Abstract Objective People diagnosed with carpal tunnel syndrome (CTS) have fibrosis between the soft, connective, and neural tissues that could worsen the compression of the median nerve. The diacutaneous fibrolysis (DF) technique may release tissue adhesions and increase the mobility of connective tissues. The purpose of this study was to compare the outcomes of DF in people with mild to moderate CTS on mechanosensitivity, disability, and nerve conduction studies. Methods This was a secondary analysis of a double-blinded, randomized placebo-controlled trial. Patients were recruited between April and September 2016 from the Department of Neurophysiology at the Hospital Miguel Servet, Zaragoza, Spain. Thirty-nine people (52 wrists) diagnosed with mild to moderate CTS were included. Participants were randomly assigned to either the DF group (n = 26) or the Sham group (n = 26). Both groups received 5 therapy sessions, 2 sessions per week. Mechanosensitivity with the Upper Limb Neurodynamic Test 1 (ULNT1), symptom severity and functional status with the Boston Carpal Tunnel Questionnaire (BCTQ), and median nerve sensory conduction velocity with nerve conduction studies were the outcomes measured. Assessments were recorded at baseline and after the intervention. Results The DF group showed significant improvements in the following: mechanosensitivity, with 28.46 degrees of elbow extension ROM (95% CI = 19.2–37.7); for BCTQ symptom severity and functional status score, with an increase of 1.0 point (95% CI = 0.7–1.4); and sensory conduction velocity of median nerve, which improved to 5.8 m/s (95% CI = 2.5–9.2). Conclusion Participants with mild to moderate CTS experienced improvements in symptom severity, functional status, mechanosensitivity, and nerve conduction studies after 5 sessions of DF.

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