Nadim Jiwa1, Alon Abraham2, Vera Bril3, Hans D Katzberg3, Leif E Lovblom4, Carolina Barnett3, Ari Breiner5. 1. Division of Neurology, University of Toronto, Toronto, Ontario, Canada. 2. Division of Neurology, Ichilov Hospital, Tel Aviv University, Tel Aviv, Israel. 3. Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Prosserman Family Neuromuscular Clinic, University Health Network, Toronto, Ontario, Canada. 4. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. 5. Division of Neurology, Department of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: abreiner@toh.ca.
Abstract
OBJECTIVE: To investigate the use of a sonographic median-to-ulnar cross-sectional area ratio (MUR) in diagnosis of carpal tunnel syndrome (CTS); and to compare the MUR with currently used sonographic parameters, and electrophysiology. METHODS: Subjects with CTS and healthy volunteers underwent ultrasound studies of the median and ulnar nerves in the wrist and forearm. Various sonographic parameters and ratios were calculated, and compared between CTS patients and controls. The sensitivity and specificity of the different parameters were compared by plotting receiver operator characteristic curves. Correlations of sonographic results with electrophysiologic studies were calculated. RESULTS: The MUR was increased in patients with CTS, in comparison with controls. A cut-point of >2.09 yielded a sensitivity of 86% and specificity of 84%. This was comparable to the currently used ultrasound metrics for CTS. The MUR also correlated with electrophysiologic severity. CONCLUSIONS: The MUR is an effective means of diagnosing CTS and correlates with electrophysiologic severity. SIGNIFICANCE: This report provides support for the use of the MUR in the sonographic diagnosis of CTS.
OBJECTIVE: To investigate the use of a sonographic median-to-ulnar cross-sectional area ratio (MUR) in diagnosis of carpal tunnel syndrome (CTS); and to compare the MUR with currently used sonographic parameters, and electrophysiology. METHODS: Subjects with CTS and healthy volunteers underwent ultrasound studies of the median and ulnar nerves in the wrist and forearm. Various sonographic parameters and ratios were calculated, and compared between CTS patients and controls. The sensitivity and specificity of the different parameters were compared by plotting receiver operator characteristic curves. Correlations of sonographic results with electrophysiologic studies were calculated. RESULTS: The MUR was increased in patients with CTS, in comparison with controls. A cut-point of >2.09 yielded a sensitivity of 86% and specificity of 84%. This was comparable to the currently used ultrasound metrics for CTS. The MUR also correlated with electrophysiologic severity. CONCLUSIONS: The MUR is an effective means of diagnosing CTS and correlates with electrophysiologic severity. SIGNIFICANCE: This report provides support for the use of the MUR in the sonographic diagnosis of CTS.