Effectiveness of ultrasonography and nerve conduction studies in the diagnosing of carpal tunnel syndrome: clinical trial on accuracy

Made available in DSpace on 2019-09-12T16:56:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2018Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: The aim of this study was to evaluate the effectiveness of two diagnostic tests routinely used for diagnosing carpal tunnel syndrome (CTS)-ultrasonography (US) and nerve conduction studies (NCS)-by comparing their accuracy based on surgical results, with the remission of paresthesia as the reference standard. Methods: We enrolled 115 patients, all of the female gender with a high probability of a clinical diagnosis of CTS. All patients underwent US and NCS for a diagnosis and subsequent surgical treatment. As a primary outcome, the accuracy of the US and NCS diagnoses was measured by comparing their diagnoses compared with those determined by the surgical outcomes. Their accuracy was secondarily evaluated based on before and after scores of the Boston Carpal Tunnel Questionnaire (BCTQ). Results: Overall, 104 patients (90.4%) were diagnosed with CTS by the surgical reference standard, 97 (84.3%) by NCS, and 90 (78.3%) by US. The concordance of NCS and surgical treatment (p < 0.001; kappa = 0.648) was superior to that of US and surgical treatment (p < 0.001; kappa = 0.423). The sensitivity and specificity of US and NCS were similar (p = 1.000 and p = 0.152, respectively: McNemar's test). The BCTQ scores were lower after surgery in patients diagnosed by both US and NCS (p < 0.001and p < 0.001, respectively: analysis of variance). Conclusions: US and NCS effectively diagnosed CTS with good sensitivity but were not effective enough to rule out a suspicion of CTS.[Rabay Pimentel, Benedito Felipe] Universidade de Taubaté (Unitau), Paraiba Valley Reg Hosp, Div Hand Surg & Upper Limb, Discipline Orthopaed & Traumatol, 239 Francisco de Barros, BR-12020230 Taubate, SP, Brazil[Rabay Pimentel, Benedito Felipe] Universidade de Taubaté (Unitau), Taubate Univ Hosp, 239 Francisco de Barros, BR-12020230 Taubate, SP, Brazil[Faloppa, Flavio; Sugawara Tamaoki, Marcel Jun; Belloti, Joao Carlos] Univ Fed Sao Paulo, Paulista Sch Med, Dept Orthoped & Traumatol, Div Hand Surg & Upper Limb, 786 Borges Lagoa, BR-04038030 Sao Paulo, SP, Brazi