Fazila Aseem1, Jessica W Williams2, Francis O Walker2, Michael S Cartwright2. 1. Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 2. Department of Neurology, Wake Forest School of Medicine, Main Floor, Reynolds Tower, Winston-Salem, North Carolina, 27157, USA.
Abstract
INTRODUCTION: Nerve conduction studies (NCS) are sensitive for carpal tunnel syndrome (CTS), but a small proportion of patients with clinical CTS have normal NCS. This retrospective study was designed to assess the neuromuscular ultrasound findings in a group of CTS patients. METHODS: The electronic medical record was reviewed by a neurologist to identify patients who had a diagnosis of CTS with normal NCS, including either mixed median-ulnar comparison or transcarpal sensory studies, and complete neuromuscular ultrasound evaluation for CTS. RESULTS: Fourteen individuals (22 wrists) met all criteria. A total of 92.3% had median nerve cross-sectional area enlargement at the wrist (mean 16.3 mm2 ), 100% had increased wrist-to-forearm median nerve area ratio (mean 2.4), 82.4% had decreased median nerve echogenicity, 75.0% had decreased median nerve mobility, and 7.1% had increased median nerve vascularity. CONCLUSION: A large proportion of patients with clinical CTS but normal NCS have abnormal neuromuscular ultrasound findings. Muscle Nerve 55: 913-915, 2017.
INTRODUCTION: Nerve conduction studies (NCS) are sensitive for carpal tunnel syndrome (CTS), but a small proportion of patients with clinical CTS have normal NCS. This retrospective study was designed to assess the neuromuscular ultrasound findings in a group of CTSpatients. METHODS: The electronic medical record was reviewed by a neurologist to identify patients who had a diagnosis of CTS with normal NCS, including either mixed median-ulnar comparison or transcarpal sensory studies, and complete neuromuscular ultrasound evaluation for CTS. RESULTS: Fourteen individuals (22 wrists) met all criteria. A total of 92.3% had median nerve cross-sectional area enlargement at the wrist (mean 16.3 mm2 ), 100% had increased wrist-to-forearm median nerve area ratio (mean 2.4), 82.4% had decreased median nerve echogenicity, 75.0% had decreased median nerve mobility, and 7.1% had increased median nerve vascularity. CONCLUSION: A large proportion of patients with clinical CTS but normal NCS have abnormal neuromuscular ultrasound findings. Muscle Nerve 55: 913-915, 2017.
Authors: Marc Dörner; Mihai Ceanga; Frank Schreiber; Jan-Hendrik Stahl; Cornelius Kronlage; Julia Wittlinger; Magdalena Kramer; Sophia Willikens; Stefanie Schreiber; Alexander Grimm; Natalie Winter Journal: Diagnostics (Basel) Date: 2021-02-09