Shawn C Roll1, Kevin R Volz2, Christine M Fahy2, Kevin D Evans2. 1. Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA. 2. School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
Abstract
INTRODUCTION: Ultrasonography may be valuable in staging carpal tunnel syndrome severity, especially by combining multiple measures. This study aimed to develop a preliminary severity staging model using multiple sonographic and clinical measures. METHODS: Measures were obtained in 104 participants. Multiple categorization structures for each variable were correlated to diagnostic severity based on nerve conduction. Goodness-of-fit was evaluated for models using iterative combinations of highly correlated variables. Using the best-fit model, a preliminary scoring system was developed, and frequency of misclassification was calculated. RESULTS: The severity staging model with best fit (rho 0.90) included patient-reported symptoms, functional deficits, provocative testing, nerve cross-sectional area, and nerve longitudinal appearance. An 8-point scoring scale classified severity accurately for 79.8% of participants. CONCLUSIONS: This severity staging model is a novel approach to carpal tunnel syndrome evaluation. Including more sensitive measures of nerve vascularity, nerve excursion, or other emerging techniques may refine this preliminary model.
INTRODUCTION: Ultrasonography may be valuable in staging carpal tunnel syndrome severity, especially by combining multiple measures. This study aimed to develop a preliminary severity staging model using multiple sonographic and clinical measures. METHODS: Measures were obtained in 104 participants. Multiple categorization structures for each variable were correlated to diagnostic severity based on nerve conduction. Goodness-of-fit was evaluated for models using iterative combinations of highly correlated variables. Using the best-fit model, a preliminary scoring system was developed, and frequency of misclassification was calculated. RESULTS: The severity staging model with best fit (rho 0.90) included patient-reported symptoms, functional deficits, provocative testing, nerve cross-sectional area, and nerve longitudinal appearance. An 8-point scoring scale classified severity accurately for 79.8% of participants. CONCLUSIONS: This severity staging model is a novel approach to carpal tunnel syndrome evaluation. Including more sensitive measures of nerve vascularity, nerve excursion, or other emerging techniques may refine this preliminary model.
Authors: Chin Chin Ooi; Siew Kune Wong; Agnes B H Tan; Andrew Y H Chin; Rafidah Abu Bakar; Shy Yunn Goh; P Chandra Mohan; Robert T J Yap; Meng Ai Png Journal: Skeletal Radiol Date: 2014-06-12 Impact factor: 2.199
Authors: Kevin D Evans; Kevin R Volz; Rachel L Pargeon; Larry T Fout; John Buford; Shawn C Roll Journal: J Ultrasound Med Date: 2014-01 Impact factor: 2.153