Korean J Neuromuscul Disord.  2020 Dec;12(2):24-31. 10.46518/kjnmd.2020.12.2.24.

The Role of Nerve Conduction Comparison Test and Ultrasonography in Diagnosing Carpal Tunnel Syndrome

• Ahn K
• Youn M
• Park JM
• Lee JJ
• Lee Ww
• Kang K
• Kim BK
• Kwon O

• KMID: 2511184
• DOI: http://doi.org/10.46518/kjnmd.2020.12.2.24

Abstract

Background
The median-to-ulnar comparison test (MUCT), and increasingly, ultrasonography (US) are considered as complementary to and more sensitive than median nerve conduction study (NCS) in diagnosing carpal tunnel syndrome (CTS).
Methods
In consecutive patients with hand paresthesia compatible with CTS but with normal median NCS, we additionally performed the MUCT and analyzed whether it yielded better diagnostic sensitivity.
Results
In total, 163 hands of clinically diagnosed CTS patients were examined with routine NCS. The MUCT and US were performed in 81 hands and 31 hands, respectively. While median NCS was diagnostic in 85 (52.1%) hands, MUCT failed to demonstrate superior sensitivity over median NCS in the other hands and US revealed related abnormalities better than both routine NCS (p=0.006) and MUCT (p=0.002).
Conclusions
The MUCT offered no additional diagnostic benefit. On the other hand, sonographic examination had higher sensitivity for the diagnosis of CTS when applying several diagnostic criteria. Thus, US could be the screening test for diagnosing CTS prior to NCS with higher sensitivity than MUCT. However, further studies are needed to define the appropriate diagnostic criteria for US.

Keyword

Carpal tunnel syndrome, Comparative study, Ultrasonography, Electromyography