The role of ultrasound in the diagnosis of carpal tunnel syndrom

Abstract

The aim of this study is to confirm the accuracy of sonography in the diagnosis of the carpal tunnel syndrome by measuring the cross-section area of the median nerve. A prospective study of 80 patients suspected of having carpal tunnel syndrome was underwent sonography at Al-Hussein Teaching Hospital in Samawa city from 1/1/2015 to 1/1/2016. The cross sectional area of the median nerve was measured at three levels, immediately proximal to carpal tunnel inlet, at carpal tunnel inlet and carpal tunnel outlet. The average value was measured. The flexor retinaculum was used as a landmark to margin of the carpal tunnel. Sensitivity and specificity of sonography were revealed as (89%) and (90%) respectively. All patients were sent for electro-diagnosis as standard reference test to compare with the values of sonography. The study proved that the sonography is sensitive but in compared with the electrodiagnosis has lower specificity. Demographic information including age, sex, side of the limb affected, and duration of the symptoms and grading of severity of the cases of the carpal tunnel syndrome were revealed. The study revealed associated disorders with the carpal tunnel syndrome such as diabetes mellitus (7 patients), pregnancy (5 patients), trauma (3 patients), hypothyroidism (1 patient), rheumatoid arthritis (1 patient), dorsal wrist ganglia (2 patients), and history of Colles’ fracture (2 patients), obese patient (12 patients), workers at manufacturing industries (3 patients) and two writers. The study proved that the sonography is easily performed, painless, rapid and available for the diagnosis of the carpal tunnel syndrome as adjuvant to electro-diagnosis but is not as substitute to it.