Christos Moschovos1, Georgios Tsivgoulis2, Andreas Kyrozis3, Apostolia Ghika3, Persefoni Karachalia4, Konstantinos Voumvourakis5, Elisabeth Chroni6. 1. Neurophysiology Unit, Iatropolis Medical Group, Athens, Halandri 15231, Greece; Second Department of Neurology, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Chaidari 12462, Athens, Greece. Electronic address: moship@windowslive.com. 2. Second Department of Neurology, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Chaidari 12462, Athens, Greece; Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA. 3. First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 4. Department of Neurology, Gennimatas General Hospital, Athens, Greece. 5. Second Department of Neurology, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Chaidari 12462, Athens, Greece. 6. Department of Neurology, School of Medicine, University of Patras, Greece.
Abstract
OBJECTIVE: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). METHODS: Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR). Healthy controls underwent identical testing (N = 122 wrists). HRUS accuracy was assessed against the EDx standard by Receiver Operator Characteristic (ROC) curve analysis. RESULTS: In patients >65 y with moderate and severe CTS, disease-related increases in CSA and WFR were negatively correlated with increasing age. Subjects were grouped by age into younger (<65 y) and older (≥65 y). The c-statistics for CSA and WFR respectively were: For CTS diagnosis, younger group: 0.94 and 0.96 (excellent); older group: 0.85 and 0.86 (satisfactory). For CTS grading, younger group: differentiating mild CTS from controls: 0.90 and 0.92 (excellent); mild from moderate: 0.79 and 0.74 (satisfactory); moderate from severe: 0.82 and 0.78 (satisfactory). For CTS grading, older group: differentiating mild CTS from controls: 0.83 and 0.83 (satisfactory); mild from moderate: 0.53 and 0.61 (poor); moderate from severe: 0.65 and 0.53 (poor). CONCLUSIONS: For subjects aged <65 y, HRUS accuracy is excellent in CTS diagnosis and satisfactory in grading. For older subjects, accuracy is satisfactory in diagnosis but not in grading. SIGNIFICANCE: HRUS for CTS has diagnostic limitations selectively in older individuals.
OBJECTIVE: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). METHODS:Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR). Healthy controls underwent identical testing (N = 122 wrists). HRUS accuracy was assessed against the EDx standard by Receiver Operator Characteristic (ROC) curve analysis. RESULTS: In patients >65 y with moderate and severe CTS, disease-related increases in CSA and WFR were negatively correlated with increasing age. Subjects were grouped by age into younger (<65 y) and older (≥65 y). The c-statistics for CSA and WFR respectively were: For CTS diagnosis, younger group: 0.94 and 0.96 (excellent); older group: 0.85 and 0.86 (satisfactory). For CTS grading, younger group: differentiating mild CTS from controls: 0.90 and 0.92 (excellent); mild from moderate: 0.79 and 0.74 (satisfactory); moderate from severe: 0.82 and 0.78 (satisfactory). For CTS grading, older group: differentiating mild CTS from controls: 0.83 and 0.83 (satisfactory); mild from moderate: 0.53 and 0.61 (poor); moderate from severe: 0.65 and 0.53 (poor). CONCLUSIONS: For subjects aged <65 y, HRUS accuracy is excellent in CTS diagnosis and satisfactory in grading. For older subjects, accuracy is satisfactory in diagnosis but not in grading. SIGNIFICANCE: HRUS for CTS has diagnostic limitations selectively in older individuals.
Authors: Melissa Airem Cázares-Manríquez; Claudia Camargo-Wilson; Ricardo Vardasca; Jorge Luis García-Alcaraz; Jesús Everardo Olguín-Tiznado; Juan Andrés López-Barreras; Blanca Rosa García-Rivera Journal: Int J Environ Res Public Health Date: 2021-04-06 Impact factor: 3.390