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Diagnostic value of cross-sectional area of median nerve in grading severity of carpal tunnel syndrome.
MedLine Citation:
PMID:  21039008     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: Carpal tunnel syndrome is a common peripheral entrapment neuropathy. The purpose of this study is to determine whether high resolution ultrasonography can be an alternative diagnostic method to nerve conduction study in grading the severity of carpal tunnel syndrome.
METHODS: A total of 164 wrists of 82 patients, bilaterally, were enrolled in the study. The cross-sectional area of the median nerve at the carpal tunnel inlet and outlet was measured in all patients with electrophysiologically confirmed carpal tunnel syndrome. All patients had nerve conduction study performed one week before ultrasonography. Then, comparisons between ultrasonography and nerve conduction study were made. The grading severity according to nerve conduction study was used as a gold standard reference.
RESULTS: The mean median nerve cross-sectional area at the tunnel inlet was 11.4±1.7 mm² for the carpal tunnel syndrome affected wrist and 5.78±0.9 mm² for the normal wrist (P<0.001). The mean median nerve cross-sectional area at the tunnel outlet was 9.9±1.2 mm² for the affected wrist with carpal tunnel syndrome and 4.7±0.7 mm² for the normal wrist (P<0.001).The best cutoff value of cross-sectional area at the tunnel inlet and outlet was 8.5 mm². The difference in cross-sectional area of the median nerve in mild, moderate and severe carpal tunnel syndrome was not statistically significant (P=0.2) neither in the carpal tunnel inlet nor outlet.
CONCLUSION: Based on this study, cross-sectional area of median nerve ultrasonography has a diagnostic value to confirm or exclude carpal tunnel syndrome, but could not be used for grading its severity.
Authors:
Afshin Mohammadi; Ahmadreza Afshar; Ardeshir Etemadi; Sima Masoudi; Atieh Baghizadeh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of Iranian medicine     Volume:  13     ISSN:  1029-2977     ISO Abbreviation:  Arch Iran Med     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889644     Medline TA:  Arch Iran Med     Country:  Iran    
Other Details:
Languages:  eng     Pagination:  516-21     Citation Subset:  IM    
Affiliation:
Department of Radiology, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran. mohamadi_afshin@yahoo.com
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