TY - JOUR
T1 - The ultrasonographic correlates of carpal tunnel syndrome in patients with normal electrodiagnostic tests
AU - Rahmani, M.
AU - Ghasemi Esfe, A. R.
AU - Bozorg, S. M.
AU - Mazloumi, M.
AU - Khalilzadeh, O.
AU - Kahnouji, H.
PY - 2011/4
Y1 - 2011/4
N2 - Purpose: The diagnosis of carpal tunnel syndrome (CTS) is established by electrodiagnostic testing (EDT). Nonetheless, in a portion of patients complaining of the typical signs and symptoms of CTS, the EDT is negative, and yet no paraclinical tool has been acknowledged for confirming the diagnosis. The aim of this study was to investigate the value of ultrasound imaging in diagnosing clinically suspicious patients with normal EDT findings. Materials and methods: Thirty-four patients, with clinical evidence of CTS but without abnormal findings on electromyography, and 41 healthy controls were enrolled. Ultrasonography was performed in all participants, and cross-sectional area (CSA), hypoechogenicity and hypervascularity of the median nerve were evaluated. Multivariate logistic regression analysis was used to formulate a prediction model for CTS. Results: CSA of the median nerve in the wrist and wrist-to-forearm ratio were significantly higher in patients compared with controls. Patients had significantly higher hypoechogenicity [odds ratio (OR) 4.317; 95% confidence interval (CI) 1.23-15.11) and hypervascularity (OR 5.004,; 95% CI 1.02-21.15) in the median nerve. Clinical evidence of CTS was predicted using a model comprising three ultrasonographic determinant factors, including hypoechogenicity, hypervascularity and wrist CSA of the median nerve. The probability of clinical evidence of CTS in a person with one, two, or three ultrasonographic signs of CTS was estimated to be 35%, 70%, and 90%, respectively. Conclusions: Ultrasound imaging is a useful technique in diagnosing CTS patients when EDT results are not confirmatory and the patient is suspected of having neuropathy.
AB - Purpose: The diagnosis of carpal tunnel syndrome (CTS) is established by electrodiagnostic testing (EDT). Nonetheless, in a portion of patients complaining of the typical signs and symptoms of CTS, the EDT is negative, and yet no paraclinical tool has been acknowledged for confirming the diagnosis. The aim of this study was to investigate the value of ultrasound imaging in diagnosing clinically suspicious patients with normal EDT findings. Materials and methods: Thirty-four patients, with clinical evidence of CTS but without abnormal findings on electromyography, and 41 healthy controls were enrolled. Ultrasonography was performed in all participants, and cross-sectional area (CSA), hypoechogenicity and hypervascularity of the median nerve were evaluated. Multivariate logistic regression analysis was used to formulate a prediction model for CTS. Results: CSA of the median nerve in the wrist and wrist-to-forearm ratio were significantly higher in patients compared with controls. Patients had significantly higher hypoechogenicity [odds ratio (OR) 4.317; 95% confidence interval (CI) 1.23-15.11) and hypervascularity (OR 5.004,; 95% CI 1.02-21.15) in the median nerve. Clinical evidence of CTS was predicted using a model comprising three ultrasonographic determinant factors, including hypoechogenicity, hypervascularity and wrist CSA of the median nerve. The probability of clinical evidence of CTS in a person with one, two, or three ultrasonographic signs of CTS was estimated to be 35%, 70%, and 90%, respectively. Conclusions: Ultrasound imaging is a useful technique in diagnosing CTS patients when EDT results are not confirmatory and the patient is suspected of having neuropathy.
KW - Carpal tunnel syndrome
KW - Electrodiagnostic tests
KW - Electromyography
KW - Ultrasonography
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U2 - 10.1007/s11547-011-0632-6
DO - 10.1007/s11547-011-0632-6
M3 - Article
C2 - 21293941
AN - SCOPUS:79955682588
SN - 0033-8362
VL - 116
SP - 489
EP - 496
JO - Radiologia Medica
JF - Radiologia Medica
IS - 3
ER -