Role of ultrasonography in patients with mild and moderate carpal tunnel syndrome

Abstract

Objective: This study aimed to determine the diagnostic value of median nerve cross-sectional area (MNCSA; mm(2)), 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 mm(2), 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 first-line diagnostic tool with electromyography.