The Importance of Ultrasound in the Diagnosis of Carpal Tunnel Syndrome in Iraqi Subjects

Abdul Bari, Ahmed; Yousif, Shamam; A. Al Sharefi, Ghalib

	The Importance of Ultrasound in the Diagnosis of Carpal Tunnel Syndrome in Iraqi Subjects
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 26, Issue 3, 2013, Pages 247-252
Authors
Ahmed Abdul Bari; Shamam Yousif; Ghalib A. Al Sharefi
Abstract
Abstract: Background: Carpal tunnel syndrome, a common peripheral entrapment neuropathy, is recognized as one of the most important causes of workplace morbidity. Diagnosis of carpal tunnel syndrome is usually based on a combination of clinical signs and nerve conduction studies. Magnetic resonance image MRI and high-resolution sonography have emerged as feasible, noninvasive imaging tools for evaluating the median nerve in the carpal tunnel. Objective: This study was designed to evaluate the use of ultrasound in diagnosis carpal tunnel syndrome. Setting: The study was held at Consulting Clinic (Rheumatology clinic) in Al Yarmouk Teaching Hospital in cooperation with Radiology department and Neurophysiology section at the period from December 2008 till May 2009. Patients & Methods: This study enrolled 50 patients with symptomatic carpal tunnel syndrome and 100 healthy volunteers as a control, with age & sex matched. Diagnosis of carpal tunnel syndrome was based on the American Academy of Neurology clinical diagnostic criteria .Electro diagnostic evaluations of nerve conduction study of median nerve for all patients group were done .Wrist sonography done by an expert radiologist who unaware of diagnosis for both patients & controls groups. Results: We found the mean of cross section area of median nerve in patients group is 0.161 cm2, while in control group is 0.072 cm2. This study showed the cut off value of cross sectional area of median nerve equal to or more than 0.092cm² give us a sensitivity equal to 90.8% , which is highly suggestive of carpal tunnel syndrome in all symptomatic subjects with carpal tunnel syndrome. The other findings of carpal tunnel syndrome detected by ultrasonography were decrease in echogenicity of median nerve with flattening of median nerve & flexor retinaculum bowing at wrist. Conclusion: From the end results we can conclude that ultrasonography may be used as the first diagnostic procedure considered in subjects with typical clinical features of carpal tunnel syndrome. Keywords: Carpal tunnel syndrome, ultrasound, nerve conduction study, median nerve.
Keywords
Carpal tunnel syndrome; ultrasound; Nerve conduction study; median nerve

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