title: Assessment of transverse ultrasonographic parameters to optimize carpal tunnel syndrome diagnosis in a case-control study.
abstract: BACKGROUND
  Transverse ultrasound measurements of the median nerve (MN) for diagnosis of carpal tunnel syndrome (CTS) suffer from inconsistent findings within and between patients and healthy subjects. The objective of this study was to improve ultrasound assessment of CTS.
  
  
  METHODS
  In a case-control study (51 patients, 25 controls) we evaluated the performance gained by: (1) correcting for ultrasound probe angulation; (2) including active parameters such as forceful gripping of the hand; and (3) including hand flexor tendon parameters.
  
  
  RESULTS
  Correcting ultrasound probe angulation increased the correct classification rate by 4.5%; including forceful gripping resulted in increasing it by 2.8%; and including the hand flexor tendon resulted in an increase of 1.3%.
  
  
  CONCLUSIONS
  The best predictive model combines correcting probe angulation with forceful gripping parameters and hand flexor tendon parameters. However, the clinically most practical model might use only probe angulation correction.
authors.affiliation: Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Centre, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands; Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Jan-Wiebe H
authors.initials: JW
authors.lastname: Korstanje
authors.forename: Richard
authors.initials: R
authors.lastname: Van Balen
authors.forename: Marjan
authors.initials: M
authors.lastname: Scheltens-De Boer
authors.forename: Joleen H
authors.initials: JH
authors.lastname: Blok
authors.forename: Harm P
authors.initials: HP
authors.lastname: Slijper
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.forename: Steven E R
authors.initials: SE
authors.lastname: Hovius
authors.forename: Ruud W
authors.initials: RW
authors.lastname: Selles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging* / Q000294:innervation; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D055815:Young Adult
keywords: carpal tunnel syndrome; ultrasound; diagnostic tool; hand dynamics; tendon; nerve