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Sonography versus nerve conduction studies in patients referred with a clinical diagnosis of carpal tunnel syndrome
Author(s) -
Pastare D.,
Therimadasamy A.K.,
Lee E.,
WilderSmith E.P.
Publication year - 2009
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20601
Subject(s) - medicine , carpal tunnel syndrome , nerve conduction , nerve conduction study , gold standard (test) , ultrasound , predictive value , entrapment neuropathy , median nerve , diagnostic accuracy , prospective cohort study , clinical diagnosis , radiology , surgery , pediatrics
Purpose. To compare the diagnostic value of high‐resolution ultrasound (US) with nerve conduction studies (NCS) in patients with clinically defined carpal tunnel syndrome (CTS). Methods. A prospective study was conducted on 66 consecutive patients investigated for sensory hand symptoms. The gold standard was the clinical diagnosis of CTS. Results. NCS showed greater diagnostic sensitivity (82%) than US (62%) in supporting a diagnosis of CTS. With increasing neurophysiologic severity of median neuropathy, there was increasing convergence of the two test methods. Abnormal US as the only diagnostic supportive evidence of CTS was rare. However, the positive predictive value of US for CTS was 100%. Conclusion. NCS show better sensitivity than US in supporting a diagnosis of CTS. However, because of its high positive predictive value, one may consider using US as a screening test, eliminating the need for NCS in the majority of clinical suspicion of CTS and reserving NCS for cases in which US is negative. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009