Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 25 , ISSUE 2 ( June, 2014 ) > List of Articles

RESEARCH ARTICLE

The Role of Musculoskeletal USG as Diagonostic Tool of CTS

P Das, R Pramanik, M Kataruka, RN Haldar, S Samanta, D Bhakat

Citation Information : Das P, Pramanik R, Kataruka M, Haldar R, Samanta S, Bhakat D. The Role of Musculoskeletal USG as Diagonostic Tool of CTS. Indian J Phy Med Rehab 2014; 25 (2):44-49.

DOI: 10.5005/ijopmr-25-2-44

Published Online: 00-06-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Over the years NCS has been used to diagnose and monitor the patients with CTS though USG has several advantages as diagnostic tool. This study has been done to find out the diagnostic accuracy of USG in CTS and to compare the efficacy of USG with standard NCS in CTS.

Prospective cross-sectional analytical study was conducted at Dept. of PM&R, IPGME&R, Kolkata from 1st March, 2012 to 31st August 2012 (6 months). Patient with clinical diagnosis of CTS of age >18 year of both sexes were included in this study and on the other hand patient with previous wrist surgery /injury, wrist deformity, diabetes mellitus, anatomical variants of median nerve on ultrasound were excluded from the study.

Methodology

After getting institutional ethical committee clearance, all patients who fulfil the above criteria were included in the study and further diagnostic conformation done by the standard diagnostic criteria of NCS. The same group of patients have been also screened by ultrasonography (USG).

Results

At the end of the study, data analysis showed that sensitivity and specificity were 92.3 and 70.0% respectively. Predictive value of +test, predictive value of -test were 88.9 and 77.8% respectively. Kappa value was 0.64 (between 0.5 and 0.7). It signifies that there is good correlation between NCS and USG as diagnostic tool of CTS. The comparison of the numerical values of median latency, amplitude and CSA USG within the groups with the help of ANOVA followed by Tukey's test showed that there was good correlation between latency and amplitude in mild, moderate, severe and profound CTS but unfortunately it was not correlated with the CSA measured by USG.

Conclusion

USG can be used for screening large population of patients as it is simple, easily available, non-invasive test and has relatively low cost and useful in evaluating and excluding local causes of nerve compression.


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  1. Incidence of common compressive neuropathies in primary care. J Neurol Neurosurg Psychiatry 2006;77:263-5.
  2. Wrist and hand. In: Russell RCG, William SNS, Bulstrode CJK, editors. Bailey and Love's Short Practice of Surgery. 24th ed. London: Arnold, 2004:518-32.
  3. Diagnosing carpal tunnel syndrome by ultrasound. J Rawalpindi Medical College 2008;12:60-5.
  4. Carpal tunnel syndrome: diagnosis, treatment, prevention and its relevance to dentistry. Ned Tijdschr Tandheelkd 2009; 116: 97-101.
  5. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syn-drome. AAEM Quality Assurance Committee. Muscle Nerve 1993;16:1392-414.
  6. Comparison of high resolution ultrasonography and nerve conduction study in the diagnosis of carpal tunnel syndrome. Diagnostic Value of Median Nerve Cross-Sectional Area Etemadi Iran. J Radiol 2009,6:147-52.
  7. The use of diagnostic ultrasound in carpal tunnel syndrome. J Hand Surg Am 2006;31:726-32.
  8. Sonographic measurement of cross-sectional area of the median nerve in the diagnosis of carpal tunnel syndrome: correlation with nerve conduction studies. J Clin Ultrasound 2009;37:125-31.
  9. Diagnosis of carpal tunnel syndrome. Ultrasound versus electromyography. Radiol Clin North Am 1999;37:859-72.
  10. Carpal tunnel syndrome: usefulness of sonography. Eur Radiol 2000;10:1920-5.
  11. J Rheumatol 2001;28:62-9.
  12. Sonography in the diagnosis of carpal tunnel syndrome. AJR Am J Roentgenol 1999;173:681-5.
  13. Diagnostic value of cross-sectional area of median nerve in grading severity of carpal tunnel syndrome. Arch Iran Med 2010;13:516.
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