Ultrasound evaluation of carpal tunnel syndrome in patients with bifid median nerve

Sripathi, Smiti and Ayachit, Anurag and Bos, Rebin (2016) Ultrasound evaluation of carpal tunnel syndrome in patients with bifid median nerve. International Journal of Research in Medical Sciences, 4 (12). pp. 5217-5223. ISSN 2320-6071

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Abstract

Background: Patients with high division of the median nerve proximal to carpal tunnel, or bifid median nerve, may present with carpal tunnel syndrome (CTS). Ultrasound (US) measurements indicative of CTS in this subset of patients differ from those in patients with non-bifid median nerve. The objectives were to evaluate the parameter ΔCSA [difference between the maximum cross-sectional area of bifid median nerve within carpal tunnel (CSAc) and outside tunnel (CSAp)] in the diagnosis of CTS, to compare sensitivity and specificity of ΔCSA with nerve conduction velocity studies (NCS), and to compare the cross-sectional area (CSAc, CSAp & ΔCSA) of bifid median nerve in CTS patients with that in asymptomatic controls. Methods: 20 wrists with bifid median nerves and symptoms suggestive of CTS were included in the study group. Nerve conduction velocity studies (NCS) were performed in all cases. 4 wrists of asymptomatic age-matched subjects had bifid median nerves and normal NCS and were included in the control group. High resolution ultrasonography was performed for all wrists and findings documented. Statistical Analysis: Receiver Operating Characteristics curves were used to obtain the level of significance (p-value) and assessment of correlation between ΔCSA and NCS findings. Results: There was significant correlation between ΔCSA and NCS. A cut-off value of 2.3mm2 gave the best calculated sensitivity (76.9 %) and specificity (100%). Conclusions: CSA criteria for diagnosing CTS in patients with bifid median nerves are different from those in patients with non-bifid median nerve. ΔCSA is a sensitive and specific parameter for confirming the diagnosis of CTS in patients with bifid median nerve with sensitivity approaching that of NCS.

Item Type: Article
Uncontrolled Keywords: Bifid median nerve; Carpal tunnel syndrome; Ultrasound.
Subjects: Medicine > KMC Manipal > Radiology
Depositing User: KMC Library
Date Deposited: 25 Mar 2017 04:02
Last Modified: 25 Mar 2017 04:02
URI: http://eprints.manipal.edu/id/eprint/148559

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