Carpal tunnel syndrome: diagnostic usefulness of sonography

Wong, Shiu Man, Griffith, James F., Hui, Andrew C. F., Lo, Sing Kai, Fu, Michael and Wong, Ka Sing 2004, Carpal tunnel syndrome: diagnostic usefulness of sonography, Radiology, vol. 323, no. 1, pp. 93-99, doi: 10.1148/radiol.2321030071.

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Title Carpal tunnel syndrome: diagnostic usefulness of sonography
Author(s) Wong, Shiu Man
Griffith, James F.
Hui, Andrew C. F.
Lo, Sing Kai
Fu, Michael
Wong, Ka Sing
Journal name Radiology
Volume number 323
Issue number 1
Start page 93
End page 99
Publisher Journals of the Radiological Society of North America (RSNA)
Place of publication Oak Brook, Ill.
Publication date 2004
ISSN 0033-8419
Keyword(s) nerves, diseases
wrist, abnormalities
Wrist, injuries
Summary PURPOSE: To prospectively evaluate accuracy of sonography for diagnosis of carpal tunnel syndrome (CTS) in patients clinically suspected of having the disease in one or both hands.
MATERIALS AND METHODS: A prospective cohort of 133 patients suspected of having CTS were referred to a teaching hospital between October 2001 and June 2002 for electrodiagnostic study. One hundred twenty patients (98 women, 22 men; mean age, 49 years; range, 19–83 years) underwent sonography within 1 week after electrodiagnostic study. Radiologist was blinded to electrodiagnostic study results. Seventy-five patients had bilateral symptoms; 23 patients, right-hand symptoms; and 22 patients, left-hand symptoms (total, 195 symptomatic hands). Cross-sectional area of median nerve was measured at three levels: immediately proximal to carpal tunnel inlet, at carpal tunnel inlet, and at carpal tunnel outlet. Flexor retinaculum was used as a landmark to margins of carpal tunnel. Optimal threshold levels (determined with classification and regression tree analysis) for areas proximal to and at tunnel inlet and at tunnel outlet were used to discriminate between patients with and patients without disease. Sensitivity, specificity, and false-positive and false-negative rates were derived on the basis of final diagnosis, which was determined with clinical history and electrodiagnostic study results as reference standard.
RESULTS: For right hands, sonography had sensitivity of 94% (66 of 70); specificity, 65% (17 of 26); false-positive rate, 12% (nine of 75); and false-negative rate, 19% (four of 21) (cutoff, 0.09 cm2 proximal to tunnel inlet and 0.12 cm2 at tunnel outlet). For left hands, sensitivity was 83% (53 of 64); specificity, 73% (24 of 33); false-positive rate, 15% (nine of 62); and false-negative rate, 31% (11 of 35) (cutoff, 0.10 cm2 proximal to tunnel inlet).
CONCLUSION: Sonography is comparable to electrodiagnostic study in diagnosis of CTS and should be considered as initial test of choice for patients suspected of having CTS.
Language eng
DOI 10.1148/radiol.2321030071
Field of Research 110320 Radiology and Organ Imaging
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, RSNA
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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