Franka Claes1, Kristel M Kasius, Jan Meulstee, Wim I M Verhagen. 1. From the Department of Neurology and Clinical Neurophysiology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands (FC, KMK, JM, WIMV); Department of Neurology, Vlietland Hospital, Schiedam, the Netherlands (FC); and Department of Neurology and Clinical Neurophysiology, St Lucas Andreas Hospital, Amsterdam, the Netherlands (KMK).
Abstract
OBJECTIVE: The aims of this study were to compare electrodiagnostic (EDX) confirmation of clinical diagnosis of carpal tunnel syndrome (CTS) with ultrasonography (US), using a new set of normal values taking wrist circumference of subjects into account, and to determine whether EDX examination can be replaced by US to confirm CTS. DESIGN: A prospective cohort of 156 patients with idiopathic CTS underwent US and EDX studies. Upper levels of normal cross-sectional area of the median nerve were established by taking wrist circumference into account and using linear regression equations. RESULTS: Of the selected patients, 83.3% met the EDX criteria for CTS. The findings from the US were normal in 67 (42.9%) of 156 patients, and within this group, the findings from the EDX were abnormal in 44 patients (65.7%). Of 89 patients with abnormal findings from the US, only 3 patients had normal findings from the EDX. CONCLUSIONS: US cannot replace EDX for confirmation of clinical diagnosis of CTS. However, an abnormal US test result has a high positive predictive value for abnormal EDX result in clinically defined CTS. US might reveal relevant anatomic information preoperatively that rarely has a direct influence on treatment management of patients with CTS. US testing, taking morphometric data into account, does not have the same diagnostic value as EDX does in confirming CTS.
OBJECTIVE: The aims of this study were to compare electrodiagnostic (EDX) confirmation of clinical diagnosis of carpal tunnel syndrome (CTS) with ultrasonography (US), using a new set of normal values taking wrist circumference of subjects into account, and to determine whether EDX examination can be replaced by US to confirm CTS. DESIGN: A prospective cohort of 156 patients with idiopathic CTS underwent US and EDX studies. Upper levels of normal cross-sectional area of the median nerve were established by taking wrist circumference into account and using linear regression equations. RESULTS: Of the selected patients, 83.3% met the EDX criteria for CTS. The findings from the US were normal in 67 (42.9%) of 156 patients, and within this group, the findings from the EDX were abnormal in 44 patients (65.7%). Of 89 patients with abnormal findings from the US, only 3 patients had normal findings from the EDX. CONCLUSIONS: US cannot replace EDX for confirmation of clinical diagnosis of CTS. However, an abnormal US test result has a high positive predictive value for abnormal EDX result in clinically defined CTS. US might reveal relevant anatomic information preoperatively that rarely has a direct influence on treatment management of patients with CTS. US testing, taking morphometric data into account, does not have the same diagnostic value as EDX does in confirming CTS.
Authors: Floriaan G C M De Kleermaeker; Jan Meulstee; Franka Claes; Kristel M Kasius; Wim I M Verhagen Journal: J Neurol Date: 2017-10-09 Impact factor: 4.849
Authors: Consuelo B Gonzalez-Suarez; Lorraine D Buenavente; Ronald Christopher A Cua; Maria Belinda C Fidel; Jan-Tyrone C Cabrera; Carina Fatima G Regala Journal: J Med Ultrasound Date: 2018-03-28