Ann Rehabil Med.  2017 Aug;41(4):595-603. 10.5535/arm.2017.41.4.595.

The Correlation Between Electrodiagnostic Results and Ultrasonographic Findings in the Severity of Carpal Tunnel Syndrome in Females

• Ha DS
• Kim HS
• Kim JM
• Lee KH

• KMID: 2389405
• DOI: http://doi.org/10.5535/arm.2017.41.4.595

Abstract

OBJECTIVE
To determine which ultrasonographic measurement can be used as an indicator reflecting the severity of carpal tunnel syndrome (CTS), by comparing electrodiagnostic results with ultrasonographic measurements in females. Many previous studies have tried to reveal that the ultrasonography (US) can possibility be used for diagnosis and severity of CTS. However, the criteria are different by gender. Thus far, there have been many efforts towards providing patients with a CTS diagnosis and severity prediction using US, but studies' results are still unclear due to lack of data on gender differences.
METHODS
We collected data from 54 female patients. We classified the severity of CTS according to electrodiagnostic results. Ultrasonographic measurements included proximal and distal cross-sectional areas of the median nerve and carpal tunnel.
RESULTS
The severity by electrodiagnostic results statistically correlated to the proximal cross-sectional area (CSA) of the median nerve and carpal tunnel. However, there was no relationship between the proximal and distal nerve/tunnel indexes and the severity by electrodiagnostic results.
CONCLUSION
In female patients with CTS, the proximal CSAs of the median nerve and carpal tunnel increase. They correlate with the severity by electrodiagnostic findings. The CSA of the proximal median nerve could be particularly used as a predictor of the severity of CTS in female patients. However, the nerve/tunnel index is constant, irrespective of the severity of CTS.

Keyword

Carpal tunnel syndrome; Electrodiagnosis; Ultrasonography; Median nerve

MeSH Terms

Carpal Tunnel Syndrome*
Diagnosis
Electrodiagnosis
Female*
Humans
Median Nerve
Ultrasonography

Figure

• 

  Fig. 1 Cross-sectional areas of the median nerve and carpal tunnel at proximal carpal tunnel level. (A) Proximal carpal tunnel, median nerve (arrow), and flexor tendon groups are shown between the pisiform and scaphoid bones. (B) Dotted outlines of median nerve and carpal tunnel are shown at proximal carpal tunnel level. S, means scaphoid bone; P, means pisiform bone.

• 

  Fig. 2 Cross-sectional areas of the median nerve and carpal tunnel at distal carpal tunnel level. (A) Proximal carpal tunnel, median nerve (arrow), and flexor tendon groups are shown between the trapezium and hook of hamate bones. (B) Dotted outlines of median nerve and carpal tunnel are shown at distal carpal tunnel level. T, means trapezium bone; H, means hook of hamate bone.

• 

  Fig. 3 Receiver operating characteristic curves of cross-sectional area of proximal median nerve. (A) Cut-off value of proximal cross-sectional area of median nerve in severity grade I is 10 mm2 (AUC=0.66, sensitivity=86.52%, 1-specificity=52.63%). (B) Cut-off value of proximal cross-sectional area of median nerve in severity grade II is 11 mm2 (AUC=0.71, sensitivity=82.27%, 1-specificity=50.94%). (C) Cut-off value of proximal cross-sectional area of median nerve in severity grade III is 12 mm2 (AUC=0.66, sensitivity=86.96%, 1-specificity=55.29%). AUC, area under the curve.

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