Highlights
- •Echo intensity of abductor pollicis brevis is higher in carpal tunnel syndrome.
- •Echo intensity is not correlated with electrodiagnostic data and symptom severity.
- •Quantitative ultrasound evaluation is helpful for the diagnosis but not for grading.
Abstract
The recent diagnostic tools for carpal tunnel syndrome (CTS) include nerve conduction
studies (NCS) and ultrasound (US). Quantitative US (QUS) can be used for demonstrating
muscle changes according to denervation. The aim of this study was to evaluate if
QUS can diagnose and grade the severity of CTS. In this single blinded cross-sectional
study, female patients diagnosed with CTS and age-matched healthy female subjects
were included in the study. Median and ulnar nerve conduction studies (NCS) were performed
for CTS diagnosis. Median and ulnar nerve cross-sectional area (CSA) was measured,
and the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles were
longitudinally and transversally visualised. Axial images were analysed for echo intensity
(EI) via computer-assisted, grayscale analysis. Intra-rater and inter-rater reliability
analysis was performed. The Boston questionnaire was used for the evaluation of symptom
severity and functional status. Forty-two patients (42 hands) and 32 controls were
included. In the CTS group, 17 patients had mild, 13 patients had moderate, and 12
patients had severe CTS. CSA of the median nerve and APB echo intensity was significantly
higher in patients with CTS. However, according to the CTS grade, no significant difference
was detected for APB EI. The intraclass correlation coefficient (ICC) was calculated
as 0.928 for intra-rater reliability and 0.768 for inter-rater reliability. QUS evaluation
is helpful for the diagnosis of CTS, but not for grading. Further studies are needed
with a larger population including both genders.
Keywords
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Article info
Publication history
Published online: March 28, 2020
Accepted:
March 21,
2020
Received:
January 12,
2020
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
