title: Carpal tunnel syndrome severity staging using sonographic and clinical measures.
abstract: BACKGROUND
  Ultrasonography may be valuable in staging carpal tunnel syndrome severity, especially by combining multiple measures. This study aimed to develop a preliminary severity staging model using multiple sonographic and clinical measures.
  
  
  METHODS
  Measures were obtained in 104 participants. Multiple categorization structures for each variable were correlated to diagnostic severity based on nerve conduction. Goodness-of-fit was evaluated for models using iterative combinations of highly correlated variables. Using the best-fit model, a preliminary scoring system was developed, and frequency of misclassification was calculated.
  
  
  RESULTS
  The severity staging model with best fit (rho 0.90) included patient-reported symptoms, functional deficits, provocative testing, nerve cross-sectional area, and nerve longitudinal appearance. An 8-point scoring scale classified severity accurately for 79.8% of participants.
  
  
  CONCLUSIONS
  This severity staging model is a novel approach to carpal tunnel syndrome evaluation. Including more sensitive measures of nerve vascularity, nerve excursion, or other emerging techniques may refine this preliminary model.
authors.affiliation: Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA.
authors.forename: Shawn C
authors.initials: SC
authors.lastname: Roll
authors.affiliation: School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Volz
authors.affiliation: School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Fahy
authors.affiliation: School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Evans
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014463:Ultrasonography
keywords: assessment; carpal tunnel syndrome; disease severity; mononeuropathy; sonography