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Ann Rehabil Med. 2017 Aug;41(4):604-609. doi: 10.5535/arm.2017.41.4.604. Epub 2017 Aug 31.

Determination of Electrophysiologically Moderate and Severe Carpal Tunnel Syndrome: Ultrasonographic Measurement of Median Nerve at the Wrist.

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1
Department of Rehabilitation Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand.

Abstract

OBJECTIVE:

To establish the cutoff value of cross-sectional area (CSA) of the median nerve at the wrist, for determination of electrophysiologically moderate and severe carpal tunnel syndrome (CTS).

METHODS:

The prospective study was conducted among patients suspected of having CTS. A total of 106 patients (185 symptomatic wrists) received nerve conduction study (NCS) and ultrasonography. To establish a cutoff value, various diagnostic properties were calculated across a range of the CSA.

RESULTS:

A mean±standard deviation of CSA of the median nerve of normal and mild, moderate and severe CTS was 9.4±2.1, 12.0±2.7, 13.8±4.7, and 15.4±4.1 mm2, respectively. The positive relationship between CTS severities and CSA was observed (rs=0.56). A 14 mm2 CSA had sufficient power to rule in moderate and severe CTS, with a specificity of 91.4% and sensitivity of 42.3%. In addition, it showed a post-test probability (positive predictive value) of 86.3% as against a pre-test probability of 56.2%.

CONCLUSION:

Patients who had ≥14 mm2 of median nerve CSA had very high probability of moderate to severe CTS.

KEYWORDS:

Carpal tunnel syndrome; Electrophysiology; Median nerve; Ultrasonography

Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

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