Carpal tunnel sonography by the rheumatologist versus nerve conduction study by the neurologist

WAA Swen*, JWG Jacobs, FEAM Bussemaker, J de Waard, JWJ Bijlsma

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    108 Citations (Scopus)

    Abstract

    Objective. To determine the value of sonogaphy (SG) performed by the rheumatologist to diagnose carpal tunnel syndrome (CTS).

    Methods. Sixty-three patients with clinical signs of CTS according to the neurologist. based on patient history and clinical examination, were studied. In the 6 weeks prior to surgery, SG was performed by a rheumatologist and nerve conduction study (NCS) was assessed. Improvement of initial complaints of 90% or more 3 months after surgery was considered to be the post-hoc gold standard for the diagnosis of CTS.

    Results. After surgery, 47 patients (75%) experienced greater than or equal to 90% relief of complaints. Mean cross sectional area of the median nerve for patients with CTS was 11.3 mm(2) compared to 6.1 mm(2) in the control group. The sensitivity to detect CTS was 0.70 for SG and 0.98 for NCS, and specificity was 0.63 for SG and 0.19 for NCS. Positive predictive value was 0.85 for SG and 0.78 for NCS; negative predictive value was 0.42 for SG and 0.75 for NCS. Accuracy was 0.68 for SG and 0.78 for NCS.

    Conclusion. CTS can be identified by SG less sensitively but more specifically than by NCS.

    Original languageEnglish
    Pages (from-to)62-69
    Number of pages8
    JournalJournal of Rheumatology
    Volume28
    Issue number1
    Publication statusPublished - Jan-2001

    Keywords

    • carpal tunnel syndrome
    • sonography
    • nerve conduction study
    • median nerve
    • nerve compression syndrome
    • rheumatologist
    • HIGH-RESOLUTION SONOGRAPHY
    • HAND FLEXOR TENOSYNOVITIS
    • RING FINGER
    • GENERAL-POPULATION
    • PREVALENCE
    • DIAGNOSIS
    • ARTHRITIS
    • ELECTROMYOGRAPHY
    • ECHOTEXTURE
    • INJECTION

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