P227 Carpal tunnel syndrome grading using high-resolution ultrasonography

Abstract

Introduction Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the wrist. The diagnosis of CTS has been a concern for physicians for a long time. The aim of this study is to evaluate the use of the median nerve (MN) cross-sectional area (CSA) in the wrist compared with the CSA in the forearm to grade the severity of carpal tunnel syndrome in Egyptian patients. Methods The cross sectional areas of the median nerve in the wrist and forearm were measured in 72 wrists that were diagnosed with carpal tunnel syndrome via nerve conduction studies (NCS) and 80 healthy wrists. The CTS group was subdivided into 3 subgroups (mild, moderate and severe CTS). The ratio of the cross sectional area of the median nerve in the wrist to that in the forearm (WFR) was used to calculate cutoff values for carpal tunnel syndrome grading. Results There were positive correlations between the CSAs of the MN in the wrist and MN conduction latency. At a WFR of 1.7, the high resolution ultrasonography (HRUS) showed 96.1% accuracy in the detection of carpal tunnel syndrome. Conclusion As the disease severity increased, the CSA in the wrist showed significant increase among all groups so HRUS could be used for carpal tunnel grading.