title: Entrapment neuropathies II: carpal tunnel syndrome.
abstract: Diagnostic tests in patients complaining of carpal tunnel syndrome (CTS) are based on physical examination, electrodiagnostic tests (EDTs), and diagnostic imaging. Timely diagnosis helps prevent permanent nerve damage and its sequelae in terms of functional impairment. Imaging provides additional information to that obtained from clinical tests and EDTs. By allowing direct visualization of the compressed median nerve (MN), ultrasound (US) and magnetic resonance imaging can depict the causes for secondary CTS and describe anatomical variants, such as a bifid MN or a persistent median artery of the forearm, as well as space-occupying lesions including tenosynovitis and ganglion cysts. In addition, diagnostic imaging is of value for postoperative patients presenting with persistent symptoms. Finally, US is able to add information for EDT-negative symptomatic patients. Over time, US has increased in its sensitivity and specificity so it can be used as the initial test in patients presenting with clinical symptoms of CTS because it is now equivalent to EDT. The use of US as a screening test may reduce the number of EDT examinations in patients with suspected CTS, providing additional valuable anatomical information.
authors.affiliation: Department of Diagnostic Radiology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria. andrea.klauser@i-med.ac.at
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Klauser
authors.forename: Ralph
authors.initials: R
authors.lastname: Faschingbauer
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauer
authors.forename: Marius C
authors.initials: MC
authors.lastname: Wick
authors.forename: Markus
authors.initials: M
authors.lastname: Gabl
authors.forename: Rohit
authors.initials: R
authors.lastname: Arora
authors.forename: Anne
authors.initials: A
authors.lastname: Cotten
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
authors.forename: Werner R
authors.initials: WR
authors.lastname: Jaschke
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology*; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones