Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and is a major cause of occupational disability. The diagnosis of carpal tunnel syndrome is based on clinical, electrophysiological, and radiographic tests. Ultrasonography is a quick, painless, and cost-effective method for confirming the diagnosis of carpal tunnel syndrome. In this comparative analysis, we examine the effectiveness of these diagnostic methods, scrutinizing their respective strengths and limitations in evaluating carpal tunnel syndrome. Materials and Methods: The present study was a correlational study, which included 60 patients with idiopathic carpal tunnel syndrome and 60 healthy controls. Only 90 wrists were used in the study among these 60 patients. We included all patients whose nerve conduction tests came out positive. Grades were assigned to each patient based on the results of nerve conduction examinations. Studies on motor and sensory nerves were conducted. Individuals with abnormal segmental or comparative tests were defined as having mild disease; those with abnormal digit/wrist sensory nerve conduction velocity and normal distal motor latency were identified as having moderate disease; and those with abnormal or prolonged distal motor latency were classified as having severe disease. Results: Out of the sixty patients, 38 had involvement in both wrists, 12 had involvement in just the right wrist, and 10 had involvement in just the left. Numbness (96.31%) was the most common symptom in the affected wrist, followed by tingling (85.63%), discomfort (75.22%), and weakness (35.67%). While 67% of the wrists had a positive Phalen’s test result, 78% of the wrists had a positive Tinel’s sign. The majority of the patients (88%) had normal vibration and 91% had normal proprioception. We found mild carpal tunnel syndrome in 50 wrists, moderate carpal tunnel syndrome in 31 wrists, while severe form was reported in only 9 wrists. The mean cross-sectional area of the median nerve in mild carpal tunnel syndrome was 8.21±1.55 mm2, in moderate carpal tunnel syndrome was 11.09±1.97 mm2 while in severe cases it was recorded at 14.85±3.87 mm2. While the mean cross-sectional area of the median nerve in the control group was 6.28 ± 1.28 mm2. Conclusions: The severity of carpal tunnel syndrome can be accurately assessed using ultrasonography, as there is a strong correlation between the increased cross-sectional area observed on ultrasonography and the severity of the condition in nerve conduction studies. Ultrasonography can be used as a cost-effective alternative to nerve conduction studies when the latter are not available.
|