title: Ultrasound imaging of the median nerve as a prognostic factor for carpal tunnel decompression.
abstract: BACKGROUND
  The diagnostic value of ultrasound imaging in carpal tunnel syndrome is established, but reports on its prognostic value have been contradictory.
  
  
  METHODS
  This investigation was an observational study of subjective surgical results, evaluated by symptom severity and functional status scales, and an ordinal scale for overall outcome, for 145 carpal tunnel decompressions in relation to preoperative measurement of median nerve cross-sectional area.
  
  
  RESULTS
  The surgical success rate was 86%. In univariate analyses no significant correlation existed between outcome and preoperative cross-sectional area, nor with preoperative nerve conduction studies or patient variables, except for body mass index and gender. A multivariate model including electrophysiological, imaging, and patient variables was moderately predictive of success with an area under the receiver operating characteristic curve of 0.82.
  
  
  CONCLUSIONS
  Cross-sectional area alone is unlikely to be a sufficiently reliable predictor of outcome for use in counseling individual patients, but imaging results may be useful in multivariate prognostic models.
authors.affiliation: Department of Clinical Neurophysiology, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent, CT1 3NG, UK.
authors.forename: Jeremy D P
authors.initials: JD
authors.lastname: Bland
authors.forename: Stephan M
authors.initials: SM
authors.lastname: Rudolfer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery; D015331:Cohort Studies; D019299:Decompression, Surgical; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009431:Neural Conduction; D009929:Organ Size; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: carpal tunnel syndrome; multivariate modeling; prognosis; surgery; ultrasound imaging