Evidence‐based guideline: Neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome

TLDR

The study aimed to develop an evidence‑based guideline for using neuromuscular ultrasound to diagnose carpal tunnel syndrome. The authors conducted a systematic review to evaluate the diagnostic accuracy of median nerve cross‑sectional area enlargement by ultrasound and its added value over electrodiagnostic studies. Ultrasound measurement of median nerve cross‑sectional area is accurate for diagnosing CTS (Level A) and likely adds value to electrodiagnostic studies, particularly for screening structural wrist abnormalities (Level B). Published in Muscle Nerve 46:287–293, 2012.

Abstract

Abstract Introduction: The purpose of this study was to develop an evidence‐based guideline for the use of neuromuscular ultrasound in the diagnosis of carpal tunnel syndrome (CTS). Methods: Two questions were asked: (1) What is the accuracy of median nerve cross‐sectional area enlargement as measured with ultrasound for the diagnosis of CTS? (2) What added value, if any, does neuromuscular ultrasound provide over electrodiagnostic studies alone for the diagnosis of CTS? A systematic review was performed, and studies were classified according to American Academy of Neurology criteria for rating articles of diagnostic accuracy (question 1) and for screening articles (question 2). Results: Neuromuscular ultrasound measurement of median nerve cross‐sectional area at the wrist is accurate and may be offered as a diagnostic test for CTS (Level A). Neuromuscular ultrasound probably adds value to electrodiagnostic studies when diagnosing CTS and should be considered in screening for structural abnormalities at the wrist in those with CTS (Level B). Muscle Nerve 46: 287–293, 2012