Diagnostic Signifcance of Ultrasonographic Measurements and Median-Ulnar Ratio in Carpal Tunnel Syndrome: Correlation with Nerve Conduction Studies
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Background and PurposezzWe determined the reliability of ultrasonography (US) measurements for diagnosing carpal tunnel syndrome (CTS) and their correlation with symptom duration and electrophysiology fndings. We determined whether the ratio of the median-to-ulnar cross-sectional areas (CSAs) can support CTS diagnoses. MethodszzTe pisiform CSA (CSApisiform ), swelling ratio (SR), palmar bowing, and CSApisiform / ulnar CSA (CSAulnar ) measurements made in two subgroups of CTS patients (having sensory afection alone or having both sensory and motor afection) were compared with controls. CSAulnar was measured in Guyon’s canal at the level of most-protuberant portion of the pisiform bone. ResultszzTe values of all of the measured US parameters were higher in patients with CTS (n=50) than in controls (n=62). CSApisiform could be used to diagnose CTS of mild severity. All of the parameters were positively correlated with the distal latency of the compound muscle action potential, and all of them except for SR were negatively correlated with the sensory nerve conduction velocity. A CSApisiform /CSAulnar ratio of ≥1.79 had a sensitivity of 70% and a specifcity of 76% for diagnosing CTS. ConclusionszzOnly CSApisiform measurements were reliable for diagnosing early stages of CTS, and CSApisiform /CSAulnar had a lower diagnostic value for diagnosing CTS.
Abstract
Background and PurposezzWe determined the reliability of ultrasonography (US) measurements for diagnosing carpal tunnel syndrome (CTS) and their correlation with symptom duration and electrophysiology fndings. We determined whether the ratio of the median-to-ulnar cross-sectional areas (CSAs) can support CTS diagnoses. MethodszzTe pisiform CSA (CSApisiform ), swelling ratio (SR), palmar bowing, and CSApisiform / ulnar CSA (CSAulnar ) measurements made in two subgroups of CTS patients (having sensory afection alone or having both sensory and motor afection) were compared with controls. CSAulnar was measured in Guyon’s canal at the level of most-protuberant portion of the pisiform bone. ResultszzTe values of all of the measured US parameters were higher in patients with CTS (n=50) than in controls (n=62). CSApisiform could be used to diagnose CTS of mild severity. All of the parameters were positively correlated with the distal latency of the compound muscle action potential, and all of them except for SR were negatively correlated with the sensory nerve conduction velocity. A CSApisiform /CSAulnar ratio of ≥1.79 had a sensitivity of 70% and a specifcity of 76% for diagnosing CTS. ConclusionszzOnly CSApisiform measurements were reliable for diagnosing early stages of CTS, and CSApisiform /CSAulnar had a lower diagnostic value for diagnosing CTS.
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