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. 2019 Aug 26:10:888.
doi: 10.3389/fneur.2019.00888. eCollection 2019.

Agreement Between High-Resolution Ultrasound and Electro-Physiological Examinations for Diagnosis of Carpal Tunnel Syndrome in the Indonesian Population

Dessy R Emril  1 , Iskandar Zakaria  2 , Mirza Amrya  1
Affiliations

Agreement Between High-Resolution Ultrasound and Electro-Physiological Examinations for Diagnosis of Carpal Tunnel Syndrome in the Indonesian Population

Dessy R Emril et al. Front Neurol. .

Abstract

Carpal tunnel syndrome (CTS) is a disorder of the wrist due to narrowing of the carpal tunnel. It can be caused by trauma or tumors in the tunnel resulting in compression of the median nerve. This disorder is often diagnosed with early symptoms such as tingling, numbness, and weakness that subsequently lead to hand muscle atrophy. While ultrasonography (USG) is one of the diagnostic methods of CTS, neurophysiological diagnosis, such as with nerve conduction study (NCS), is standard in clinics where the necessary equipment is available. This cross-sectional study aimed to compare USG diagnostic values with NCS results to determine USG efficacy for diagnosis of CTS. Data on medical history, physical examination, ultrasound results, and NCS examination from patients who had been diagnosed with CTS at a regional general hospital in Indonesia were collected. In total, 46 patients participated in the study and data were compared using 2 × 2 table analyses and the kappa statistic. Results showed USG sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and accuracy values of 88.5, 65, 76.6, 81.25, 2.52, 0.17, and 78.2%, respectively (p < 0.005). Comparison between NCS and the USG assessment obtained a kappa coefficient of κ = 0.71 and showed high agreement (κ = 0.410.60). In conclusion, the diagnostic value of USG compared to NCS is acceptable. Therefore, USG examination is a feasible CTS diagnostic alternative for clinicians who do not have access to an electrodiagnostic facility.

Keywords: carpal tunnel syndrome; electrodiagnostic; kappa value; sensitivity; specificity; ultrasonography.

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Figures

Figure 1
Figure 1
Transverse images of the median nerve with cross-sectional area measurements at two levels: (A) CSAc at the wrist fold and (B) CSAp at the pronator quadratus muscle.
Figure 2
Figure 2
ROC Curve of ultrasonography results.
See this image and copyright information in PMC

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