Background: Attaining gold standard test for confirming diagnosis and grading carpal tunnel syndrome (CTS) remained a challenge. Ultrasonography (US) is advocated as simple noninvasive method for CTS diagnosis. Objective: This study is aimed to evaluate the diagnostic value of ultrasonography in CTS. Methods: Fifty CTS patients (mean age 38.94 ± 11.85 years, 46 females and 4 males) underwent full history taking, Boston Carpal tunnel syndrome questionnaire, clinical examination including provocative tests and NCS. Ultrasonography was carried out for all patients and for twenty five; age and sex matched; healthy individuals as a control group. Results: US sensitivity, specificity, positive and negative predictive values were 90.4, 70.6, 93.8 and 60% respectively. Sonographic criteria of CTS were found in all patients including those with normal NCS. Significant correlation exists between US findings and all the neurophysiological measures. But poor agreement were encountered between neurophysiological and US grading. Conclusion: Ultrasonographic examination of the median nerve seems to be a promising method in the diagnosis of carpal tunnel syndrome particularly in mild cases, but not in grading it. Ultrasound has a complementary role to NCS in the diagnosis of clinically symptomatic CTS cases with normal nerve conduction. Further studies with wider series are needed to confirm our preliminary results. [Egypt J Neurol Psychiat Neurosurg. 2011; 48(3): 207-214]
Key Words: Carpal tunnel syndrome, Nerve conduction study, Ultrasonography.
Correspondence to Hala A. Shaheen, Department of Neurology, Fayoum University, Egypt. Tel.: +20107965888. Email: Shaheen.hala@yahoo.com