The Usefulness of Ultrasonography in the Diagnosis of Carpal Tunnel                     Syndrome

This study assessed the use of ultrasound in the diagnosis of carpal tunnel syndrome and to determine the best ultrasound criterion for diagnosis. Forty wrists of 27 patients with surgically proven moderate and severe carpal tunnel syndrome and 30 wrists of 15 controls were examined. Measurements of the cross-sectional area and the anteroposterior diameter of the median nerve at the inlet and outlet of the carpal tunnel were obtained. Patients also underwent electrophysiological evaluation. Median nerve ultrasonographic measurements were significantly higher in patients. The cross-sectional area of the median nerve at the tunnel inlet was found to be the most useful diagnostic criterion. The optimal cut-off value was 6.5 mm2 (sensitivity 89.5%, specificity 93%). Ultrasound parameters failed to correlate with the electrophysiological findings. The usefulness of ultrasonography in the diagnosis of carpal tunnel syndrome is discussed.

Download Full-text

Reduction in median nerve cross-sectional area at the forearm correlates with axon loss in carpal tunnel syndrome

Clinical Neurophysiology Practice ◽

10.1016/j.cnp.2021.06.001 ◽

2021 ◽

Author(s):

Lauri Martikkala ◽

Katri Mäkelä ◽

Sari-Leena Himanen

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Axon Loss ◽

Tunnel Syndrome

Download Full-text

Cross-Sectional Area of the Median Nerve Characterized by Ultrasound in Patients With Carpal Tunnel Syndrome Before and After the Release of the Transverse Carpal Ligament

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479313477731 ◽

2013 ◽

Vol 29 (3) ◽

pp. 116-121 ◽

Cited By ~ 2

Author(s):

Benedito F. Pimentel ◽

Claudia A. Abicalaf ◽

Larissa Braga ◽

Walter M. Albertoni ◽

Carlos H. Fernandes ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Cross Sectional Area ◽

Sectional Area ◽

Transverse Carpal Ligament ◽

Cross Sectional ◽

Before And After ◽

Tunnel Syndrome

Download Full-text

Ultrasound Assessment of the Median Nerve Does Not Adequately Discriminate the Carpal Tunnel Syndrome among Patients Diagnosed with Diabetes

Diabetology ◽

10.3390/diabetology2040020 ◽

2021 ◽

Vol 2 (4) ◽

pp. 226-231

Author(s):

Carlos Antonio Guillen-Astete ◽

Monica Luque-Alarcon ◽

Nuria Garcia-Montes

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Cross Sectional Area ◽

Diabetic Patients ◽

Sectional Area ◽

Cross Sectional ◽

Patients With Diabetes ◽

Ultrasound Assessment ◽

Tunnel Syndrome

Background: Carpal tunnel syndrome is the most prevalent peripheral nerve entrapment condition of the upper limb. Among metabolic risk factors, diabetes is considered the most relevant. Although wrist ultrasound assessment of the median nerve has demonstrated a good correlation with the gold standard for the diagnosis of this syndrome, neurophysiological study, its usefulness in patients with diabetes is questionable because the compressive phenomenon is not the predominant one. Method: We conducted a retrospective study to compare the clinical and median nerve ultrasound features of patients with carpal tunnel syndrome previously diagnosed or not diagnosed with diabetes. Additionally, a linear multivariate regression analysis was performed to determine to what extent the cross-sectional area of the median nerve was dependent on the condition of diabetes by fixing other variables such as sex, age, or time of evolution. Results: We included 303 records of patients (mean age 44.3 ± 11.7 years old, 57.89% female, mean of time of evolution 13.6 ± 8.3 months) from 2012 to 2020. The cross-sectional area of the median nerve was 10.46 ± 1.44 mm2 in non-diabetic patients and 8.92 ± 0.9 mm2 in diabetic patients (p < 0.001). Additionally, diabetic patients had a shorter time of evolution (7.91 ± 8.28 months vs. 14.36 ± 0.526 months, p < 0.001). In the multivariate analysis, the resultant model (fixed R-square = 0.659, p = 0.003) included a constant of the following four variables: the evolution time (Beta coeff. = 0.108, p < 0.001 95% CI 0.091 to 0.126, standardized coeff. = 0.611), the condition of diabetes (Beta coeff. = −0.623, p < 0.001 95% CI −0.907 to −0.339, standardized coeff. = −0.152), the severity (Beta coeff. = 0.359, p = 0.001 95% CI 0.147 to 0.571, standardized coeff. = 0.169), and the masculine sex (Beta coeff. = 0.309, p = 0.003, 95% CI 0.109 to 0.509, standardized coeff. = 0.103). Conclusions: Ultrasound assessment of the median nerve in patients with diabetes is not a useful tool to confirm whether carpal tunnel syndrome should be diagnosed or not diagnosed.

Download Full-text