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Median nerve ultrasound as a screening tool in carpal tunnel syndrome: Correlation of cross-sectional area measures with electrodiagnostic abnormality

Authors

  • Justin T. Mhoon MD,

    Corresponding author
    1. Department of Medicine, Division of Neurology, Duke University Medical Center, 3116 N Duke Street, Durham, North Carolina 27704, USA
    • Department of Medicine, Division of Neurology, Duke University Medical Center, 3116 N Duke Street, Durham, North Carolina 27704, USA
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  • Vern C. Juel MD,

    1. Department of Medicine, Division of Neurology, Duke University Medical Center, 3116 N Duke Street, Durham, North Carolina 27704, USA
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  • Lisa D. Hobson-Webb MD

    1. Department of Medicine, Division of Neurology, Duke University Medical Center, 3116 N Duke Street, Durham, North Carolina 27704, USA
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Abstract

Introduction: Sonographically measured median nerve cross-sectional area (CSA) at the wrist is increased in patients with carpal tunnel syndrome (CTS). Ultrasound of the median nerve may be useful in screening for electrodiagnostic (EDx) abnormalities. Methods: EDx studies were performed on all participants. Sonographic evaluation of median nerve CSA at the wrist and in the forearm was performed by a physician blinded to the EDx results. Multivariate and receiver operating characteristic (ROC) analysis were used to assess the data. Results: Fifty control wrists and 192 symptomatic wrists were analyzed. Sensitivity of ultrasound in excluding EDx abnormality was 99% for CSA of 9 mm2 and 97% for a wrist–forearm ratio (WFR) of 1.4. There was no clinically significant correlation between ultrasound parameters and EDx severity. Conclusions: Median nerve ultrasound is a highly sensitive screening tool for EDx abnormality, but it cannot determine severity. This may lead to changes in the current standards for evaluating CTS. Muscle Nerve, 2012

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