The role of magnetic resonance imaging in carpal tunnel syndrome. Correlation of clinical, electrodiagnostic, and intraoperative findings and staging

Abstract

A prospective, single-blind study was planned to investigate the role of magnetic resonance imaging (MRI) in the diagnosis, treatment, and staging of carpal tunnel syndrome (CTS). The study group was comprised of 43 hands of 25 patients (21 women, 4 men; mean age 56 years) with a clinical diagnosis of CTS. Fifteen patients (12 women, 3 men; mean age 51 years) with ganglions on the dorsal side of the wrist constituted the control group. Comparisons were made between MRI findings, clinical findings, electrodiagnostic test results, and intraoperative findings. Electrodiagnostic test results were positive in 36 (84%) and negative in seven hands (16%). Magnetic resonance imaging revealed positive findings for CTS in all patients. A significant difference was found between the study and control groups in the carpal tunnel measurements at the level of the hook of the hamate (p<0.005). In addition, MRI showed space occupying lesions within the carpal tunnel in three patients, and a bilateral anomaly of the median nerve in one patient. It was found that MRI offered objective findings for the diagnosis, treatment, and staging of CTS, which were in good correlation with clinical findings, electrodiagnostic test results, and intraoperative observations. Moreover, it was helpful in the diagnosis when there had been discrepancy between clinical findings and electrodiagnostic test results.