title: Ultrasound evaluation of patients with moderate and severe carpal tunnel syndrome.
abstract: The objective of this study is to determine cut-off points for the crosssectional             areas of the median nerve proximal and distal to carpal tunnel in moderate             and severe Carpal Tunnel Syndrome (CTS) and compare the results of our study             with those available in the literature. Forty-three patients with upper limb pain             other than CTS and 36 patients with idiopathic CTS enrolled into the study. The             diagnosis and categorization of CTS were based on electrophysiologic criteria of             the American Academy of Neurology. Median nerve cross-sectional areas were             measured. Arithmetic mean values and standard deviation of each variable were             measured. Student t-test and chi-squared test were applied to compare continuous             and dichotomous variables between CTS and non-CTS control groups. Ultimately             the diagnostic performances of the test characteristics including sensitivity, specificity,             positive and negative predictive values were measured. Mean cross-sectional area             of the nerve is higher in moderate than severe CTS proximal and distal to carpal             tunnel. We accepted cut-off points of 11.5 mm² and 13.5 mm² for cross-sectional             areas of the proximal and distal portions of carpal canal respectively. The sensitivity,             specificity, positive and negative predictive values for the proximal inlet are 83%,             90.7%, 65.5% and 55.7%; and for the distal outlet are 36.1%, 93%, 81.2% and 63.4%             respectively. We suggest that ultrasound is a good diagnostic modality for patients             referred to tertiary care centers which categorized as moderate CTS.
authors.affiliation: Department of Neurology, Zahedan University of Medical Sciences, Zahedan, Iran. moghtaderi@zaums.ac.ir
authors.forename: A
authors.initials: A
authors.lastname: Moghtaderi
authors.forename: S
authors.initials: S
authors.lastname: Sanei-Sistani
authors.forename: N
authors.initials: N
authors.lastname: Sadoughi
authors.forename: H
authors.initials: H
authors.lastname: Hamed-Azimi
mesh_terms: D000200:Action Potentials; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult