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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Musculoskeletal Disorders 1/2018

Effectiveness of ultrasonography and nerve conduction studies in the diagnosing of carpal tunnel syndrome: clinical trial on accuracy

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2018
Autoren:
Benedito Felipe Rabay Pimentel, Flávio Faloppa, Marcel Jun Sugawara Tamaoki, João Carlos Belloti
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12891-018-2036-4) contains supplementary material, which is available to authorized users.

Abstract

Background

The aim of this study was to evaluate the effectiveness of two diagnostic tests routinely used for diagnosing carpal tunnel syndrome (CTS)—ultrasonography (US) and nerve conduction studies (NCS)—by comparing their accuracy based on surgical results, with the remission of paresthesia as the reference standard.

Methods

We enrolled 115 patients, all of the female gender with a high probability of a clinical diagnosis of CTS. All patients underwent US and NCS for a diagnosis and subsequent surgical treatment. As a primary outcome, the accuracy of the US and NCS diagnoses was measured by comparing their diagnoses compared with those determined by the surgical outcomes. Their accuracy was secondarily evaluated based on before and after scores of the Boston Carpal Tunnel Questionnaire (BCTQ).

Results

Overall, 104 patients (90.4%) were diagnosed with CTS by the surgical reference standard, 97 (84.3%) by NCS, and 90 (78.3%) by US. The concordance of NCS and surgical treatment (p < 0.001; kappa = 0.648) was superior to that of US and surgical treatment (p < 0.001; kappa = 0.423). The sensitivity and specificity of US and NCS were similar (p = 1.000 and p = 0.152, respectively: McNemar’s test). The BCTQ scores were lower after surgery in patients diagnosed by both US and NCS (p < 0.001and p < 0.001, respectively: analysis of variance).

Conclusions

US and NCS effectively diagnosed CTS with good sensitivity but were not effective enough to rule out a suspicion of CTS.

Trial registration

This study was registered at September, 10 th, 2015, and the registration number was NCT02553811.
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