Abstract
BackgroundTo evaluate the diagnostic accuracy of the median-to-ulnar nerve ratio (MUR) and the median-to-ulnar nerve difference (MUD) in patients with carpal tunnel syndrome (CTS).MethodsIn this study, 32 patients with CTS and 32 healthy volunteers were evaluated. All participants received a series of tests and ultrasound examination for the evaluation of the following criteria: cross-sectional area of the median nerve at the pisiform level (CSA-P), swelling ratio (SR), MUR, MUD, and flattening ratio (FR).ResultsCSA-P, SR, MUR, and MUD were all significantly larger in the patients with CTS than in the healthy volunteers. The areas under the receiver operator characteristic curves of MUD, MUR, CSA-P, and SR were 0.78, 0.75, 0.70, and 0.61 respectively. MUD had higher sensitivity (84%) than MUR, CSA-P, and SR (sensitivity: 63, 63, and 53%, respectively).ConclusionsBy using the ulnar nerve area at the pisiform level as an internal control parameter, the MUD and MUR methods showed higher diagnostic accuracy than SR in patients with CTS. Further application of these methods in research and clinical settings is recommended.Trial registrationClinicaltrial.gov NCT03033173. Registered 18 January 2017. Retrospectively registered.
Highlights
To evaluate the diagnostic accuracy of the median-to-ulnar nerve ratio (MUR) and the median-toulnar nerve difference (MUD) in patients with carpal tunnel syndrome (CTS)
body mass index (BMI) was significantly higher in the patients with CTS (P = 0.01) than in the healthy volunteers
The symptoms severity score and functional status score were significantly higher in the patients with CTS (P < 0.0001) than in the healthy volunteers
Summary
To evaluate the diagnostic accuracy of the median-to-ulnar nerve ratio (MUR) and the median-toulnar nerve difference (MUD) in patients with carpal tunnel syndrome (CTS). All participants received a series of tests and ultrasound examination for the evaluation of the following criteria: cross-sectional area of the median nerve at the pisiform level (CSA-P), swelling ratio (SR), MUR, MUD, and flattening ratio (FR). Carpal tunnel syndrome (CTS) is a common compressive neuropathy of the median nerve at the wrist level; it accounts for 90% of entrapment neuropathy cases. Patients are initially assessed for clinical symptoms such as numbness, tingling, or hyperesthesia over the median nerve innervating digits. Symptoms might aggravate nocturnally or be induced after prolonged wrist flexion or extension.
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