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Carpal tunnel syndrome severity staging using sonographic and clinical measures
Author(s) -
Roll Shawn C.,
Volz Kevin R.,
Fahy Christine M.,
Evans Kevin D.
Publication year - 2015
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.24478
Subject(s) - carpal tunnel syndrome , medicine , median nerve , carpal tunnel , vascularity , ultrasonography , severity of illness , physical therapy , physical medicine and rehabilitation , radiology , surgery
Ultrasonography may be valuable in staging carpal tunnel syndrome severity, especially by combining multiple measures. This study aimed to develop a preliminary severity staging model using multiple sonographic and clinical measures. Methods Measures were obtained in 104 participants. Multiple categorization structures for each variable were correlated to diagnostic severity based on nerve conduction. Goodness‐of‐fit was evaluated for models using iterative combinations of highly correlated variables. Using the best‐fit model, a preliminary scoring system was developed, and frequency of misclassification was calculated. Results The severity staging model with best fit (rho 0.90) included patient‐reported symptoms, functional deficits, provocative testing, nerve cross‐sectional area, and nerve longitudinal appearance. An 8‐point scoring scale classified severity accurately for 79.8% of participants. Conclusions This severity staging model is a novel approach to carpal tunnel syndrome evaluation. Including more sensitive measures of nerve vascularity, nerve excursion, or other emerging techniques may refine this preliminary model. Muscle Nerve 51 : 838–845, 2015