Reliability of measurement of the carpal tunnel and median nerve in asymptomatic subjects with ultrasound

Abstract

Background: Morphology of the carpal tunnel changes with varying wrist postures and compressive forces applied to the wrist. These changes may affect the morphology and pressure on the median nerve and could be used as part of the treatment of the carpal tunnel syndrome patients. Reliability of the ultrasonographic measurements of the median nerve has been widely studied. However, there is a lack of investigation regarding reliability of ultrasonographic measurements of the carpal tunnel.

Objective: The purpose of this study was to assess intra-tester and inter-tester reliability of measurement of dimensions of the carpal tunnel and median nerve with ultrasound in asymptomatic volunteers.

Design: A cross-sectional methodological study.

Methods: Aspects measured were mediolateral and anteroposterior diameters, flattening ratio, circularity, perimeter and cross-section area of the carpal tunnel and median nerve.

Results: Intra-tester reliability was excellent for the carpal tunnel (ICCs from 0.91 to 0.97) and for the median nerve (ICCs from 0.79 to 0.94) measurements. The flattening ratio of the median nerve showed good agreement (ICC = 0.68). Inter-tester reliability was excellent for the carpal tunnel measurements (ICCs from 0.76 to 0.95) and, for the cross sectional area, the perimeter and mediolateral diameter of the median nerve, the ICC values were 0.89, 0.84 and 0.81, respectively.

Conclusion: In the context of this study, ultrasound was a reliable instrument for measuring carpal tunnel and median nerve dimensions in asymptomatic subjects.

Level of evidence: 1b.

Keywords: Carpal tunnel syndrome; Median nerve; Reproducibility; Ultrasonography.