Sonography in carpal tunnel syndrome with normal nerve conduction studies

Muscle Nerve. 2015 Apr;51(4):592-7. doi: 10.1002/mus.24425. Epub 2015 Feb 24.

Abstract

Introduction: We assessed the yield of high-resolution ultrasonography (HRUS) in patients with clinically definite carpal tunnel syndrome (CTS) and normal nerve conduction studies (NCS).

Methods: This blinded, prospective, cross-sectional study involved 35 patients (60 hands) with clinically definite CTS and normal NCS, and 20 controls (40 hands). Cross-sectional area (CSAs) of the median nerve at the level of the pisiform bone and flexor retinaculum thickness (FRT) were measured.

Results: CSA was abnormal in 48.6% of patients (confidence interval 32.0-65.2%, P = 0.95). FRT was increased in only 34.3% (18.3-49.7%), but was independently abnormal in 2 patients. CSA abnormalities correlated with positive provocative tests and sensory loss. The HRUS changes were mild.

Conclusions: HRUS confirms clinically diagnosed CTS in about half of the patients with normal NCS.

Keywords: CTS; carpal tunnel syndrome; median nerve; mononeuropathy; nerve conduction studies; ultrasound.

MeSH terms

  • Adult
  • Carpal Tunnel Syndrome / diagnostic imaging*
  • Cross-Sectional Studies / methods
  • Female
  • Hand / diagnostic imaging*
  • Humans
  • Male
  • Median Nerve / diagnostic imaging*
  • Middle Aged
  • Neural Conduction / physiology*
  • Prospective Studies
  • Ultrasonography
  • Young Adult