Grift, A.W.F. (2016) Diagnosing Carpal Tunnel Syndrome : Sensitivity of ultrasonography versus nerve conduction study and their necessity. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
GriftAWF.pdf Restricted to Registered users only Download (1MB) |
Abstract
Introduction. Carpal Tunnel Syndrome (CTS) is the most common nerve entrapment of the upper extremity and results from an entrapment of the median nerve beneath the flexor retinaculum at the wrist. The prevalence of CTS is high (5% to 15%) among the general population, with women five times more affected than men. Symptoms of CTS are pain, tingling in the median nerve distribution area of the hand, numbness, weakness, nocturnal paresthesia, hypotrophy and/or paresis of the thenar musculature, dropping items due to loss of sensory and/or motor function, and/or decreased sweat function. There is no golden standard for diagnosing CTS. Nerve conduction study (NCS) and ultrasonography (US) are the most used examinations for confirming clinical CTS. Although NCS is frequently used to diagnose CTS, the rate of false-negatives can be as high as 10% to 34%. Also, NCS is time consuming and uncomfortable for patients. In order to determine whether the diagnosis CTS could be made by US only so NCS would be unnecessary, the aim of this study is to examine the sensitivity of US and NCS of the median nerve related to the clinical symptoms in diagnosing CTS. Methods. In this retrospective study, a database with patients with clinical CTS was used. Clinical symptoms, US outcomes and NCS outcomes were retrieved from medical records. The outcomes of US and NCS were analyzed in three groups: an overall CTS group, a typical CTS group and an atypical CTS group. The primary study outcomes were the outcomes of US and NCS in these groups. The secondary study outcome was the sensitivity of US and NCS in patients with clinical CTS. Results. A total of 92 wrists from 57 patients were analyzed (67 (72,8%) wrists of women): 54 (57,7%) wrists in the typical CTS group and 38 (42,3%) wrists in the atypical CTS group. US was positive in 73,9%, 72,2% and 76,3% of the overall group, the typical CTS group and the atypical CTS group, respectively. NCS was positive in 81,5%, 79,6% and 84,2% in the overall group, the typical CTS group and the atypical CTS group, respectively. The sensitivity of US and NCS in the overall group was 73,9% and 81,5%, respectively (p 0,204). In the typical CTS group, the sensitivity for US and NCS was 72,2% and 79,6%, respectively (p 0,289). In the atypical CTS group, the sensitivity for US and NCS was 76,3% and 84,2%, respectively (p 0,238). Conclusion. This study showed that the sensitivity of US is comparable with the sensitivity of NCS in the overall CTS group, the typical CTS group and atypical CTS group. Although there was no significant difference between US and NCS, US could be preferred as first examination to confirm the diagnosis CTS, because this examination is less uncomfortable for patients in comparison with NCS. Further prospective and blinded studies are needed to confirm these outcomes.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Houpt, Dr. P. Plastic Surgeon and Plastic Surgery, Isala Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:06 |
| Last Modified: | 25 Jun 2020 11:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2595 |
Actions (login required)
 |
View Item |