Ultrasound for carpal tunnel syndrome screening in manual laborers

Authors

  • Michael S. Cartwright MD, MS,

    Corresponding author
    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    • Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Francis O. Walker MD,

    1. Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Jill N. Blocker MS,

    1. Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Mark R. Schulz PhD,

    1. Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
    Search for more papers by this author
  • Thomas A. Arcury PhD,

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Joseph G. Grzywacz PhD,

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Dana Mora MPH,

    1. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Haiying Chen PhD,

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Antonio J. Marín MA,

    1. Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author
  • Sara A. Quandt PhD

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    Search for more papers by this author

  • This study was supported by the CDC/NIOSH (R01OH009251 to S.A.Q.) to study occupational injuries in Latino poultry processing workers and by the NIH/NINDS (1K23NS062892 to M.S.C.) to study neuromuscular ultrasound.

Correspondence to: M.S. Cartwright; e-mail: mcartwri@wakehealth.edu

ABSTRACT

Introduction

Manual laborers are at increased risk for carpal tunnel syndrome (CTS), and a combination of history, physical examination, and nerve conduction studies is often used to screen for CTS in this population. Neuromuscular ultrasound may be a better screening tool, because it is painless. In this study we compare the accuracy of nerve conduction studies and ultrasound for CTS screening.

Methods

Five hundred thirteen manual laborers were screened prospectively for CTS using nerve conduction studies and neuromuscular ultrasound, and the accuracy of the 2 techniques was compared using the Katz hand diagram as the diagnostic standard.

Results

The ROC curves for the 2 techniques were not significantly different (P = 0.542), indicating that the approaches had similar diagnostic accuracy.

Conclusions

Neuromuscular ultrasound is a painless technique that has diagnostic accuracy similar to nerve conduction studies and can be used to screen large populations at risk for CTS. Muscle Nerve, 2013

Ancillary