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The relationship between ultrasonography findings and physical examination findings in carpal tunnel syndrome

Objective: In this study, we aimed to determine the reliability of median nerve measurements obtained by ultrasonography in the diagnosis of Carpal Tunnel Syndrome and to determine the correlation with Tinel’s and Phalen’s sign test which are the diagnostic methods in order for clinical physical examination.

Materials and Methods: Hand wrists of 36 patients were diagnosed as Carpal Tunnel Syndrome with anamnesis, clinical findings and electrophysiological (EMG) examinations which were examined with high resolution ultrasonography including 12 MHz linear probes performing by a neurology clinic. All the wrists were evaluated in neutral position with the palms up and the fingers half-extended. The transverse and anteroposterior diameters of the median nerve and cross sectional areas were measured at the level of the pisiform bone at the proximal carpal tunnel. Median nerve measurements between patient group and control group and clinical findings which are Tinel’s and Phalen’s sign test results of the patient group were compared with median nerve measurements.

Results: 86 wrists of 66 patients were examined. The transverse and anteroposterior diameters of the median nerve and cross-sectional areas obtained by direct method were calculated in both the patient group and the control group. In the patient group, averages of transverse and anteroposterior diameters of median nerve and means of cross sectional area obtained by direct method were higher than the control group and there was a statistically significant difference (p<0.05).

Conclusion: Ultrasound diagnosis of Carpal Tunnel Syndrome has much more superior diagnostic value than Tinel’s and Phalen’s sign tests, which are the clinical diagnostic methods.

Author(s): Semih Saglik, Gokhan Demirtas