title: Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures.
abstract: OBJECTIVE
  To study the diagnostic properties of hand/wrist and body measures according to validated clinical and electrophysiological carpal tunnel syndrome (CTS) severity scales.
  
  
  METHODS
  We performed a prospective case-control study. For each case, two controls were enrolled. Two five-stage clinical and electrophysiological scales were used to evaluate CTS severity. Anthropometric measurements were collected and obesity indicators and hand/wrist ratios were calculated. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and likelihood ratios were calculated separately by gender.
  
  
  RESULTS
  We consecutively enrolled 370 cases and 747 controls. The wrist-palm ratio, waist-hip-height ratio and waist-stature ratio showed the highest proportion of cases with abnormal values in the severe stages of CTS for clinical and electrophysiological severity scales in both genders. Accuracy tended to increase with CTS severity for females and males. In severe stage, most of the indexes presented moderate accuracy in both genders. Among subjects with severe CTS, the wrist-palm ratio presented the highest AUC for hand measures in the clinical and electrophysiological severity scales both in females (AUC 0.83 and 0.76, respectively) and males (AUC 0.91 and 0.82, respectively). Among subjects with severe CTS, the waist-stature ratio showed the highest AUC for body measures in the clinical and electrophysiological severity scales both in females (AUC 0.78 and 0.77, respectively) and males (AUC 0.84 and 0.76, respectively). The results of waist-hip-height ratio AUC were similar.
  
  
  CONCLUSIONS
  Wrist-palm ratio, waist-hip-height ratio and waist-stature ratio could contribute to support the diagnostic hypothesis of severe CTS that however has to be confirmed by nerve conduction study.
authors: EMG Service, Local Health Unit no.7, Siena, Italy.
authors: Mauro
authors: M
authors: Mondelli
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Andrea
authors: A
authors: Farioli
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Stefano
authors: S
authors: Mattioli
authors: EMG Service, Local Health Unit no.7, Siena, Italy.
authors: Alessandro
authors: A
authors: Aretini
authors: Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.
authors: Federica
authors: F
authors: Ginanneschi
authors: EMG Service, Local Health Unit no.7, "Nottola" Hospital, Montepulciano, Siena, Italy.
authors: Giuseppe
authors: G
authors: Greco
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Stefania
authors: S
authors: Curti
mesh_terms: D000886:Anthropometry; D002349:Carpal Tunnel Syndrome / Q000473:pathology* / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006225:Hand / Q000473:pathology*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index