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Assessment of transverse ultrasonographic parameters to optimize carpal tunnel syndrome diagnosis in a case–control study

Authors

  • Jan-Wiebe H. Korstanje MSc, PhD,

    Corresponding author
    1. Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
    2. Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Richard Van Balen MSc,

    1. Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Marjan Scheltens-De Boer MD,

    1. Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Joleen H. Blok PhD,

    1. Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Harm P. Slijper PhD,

    1. Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
    2. Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Henk J. Stam MD, PhD,

    1. Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Steven E.R. Hovius MD, PhD,

    1. Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • Ruud W. Selles PhD

    1. Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
    2. Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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  • This study was supported by a grant from Nuts-OHRA.

ABSTRACT

Introduction: Transverse ultrasound measurements of the median nerve (MN) for diagnosis of carpal tunnel syndrome (CTS) suffer from inconsistent findings within and between patients and healthy subjects. The objective of this study was to improve ultrasound assessment of CTS. Methods: In a case–control study (51 patients, 25 controls) we evaluated the performance gained by: (1) correcting for ultrasound probe angulation; (2) including active parameters such as forceful gripping of the hand; and (3) including hand flexor tendon parameters. Results: Correcting ultrasound probe angulation increased the correct classification rate by 4.5%; including forceful gripping resulted in increasing it by 2.8%; and including the hand flexor tendon resulted in an increase of 1.3%. Conclusions: The best predictive model combines correcting probe angulation with forceful gripping parameters and hand flexor tendon parameters. However, the clinically most practical model might use only probe angulation correction. Muscle Nerve 48: 532–538, 2013

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