Idiopathic carpal tunnel syndrome (ICTS): Correlation between nerve conduction studies and dynamic wrist ultrasonography

Purpose To evaluate accuracy of ultrasound in assessment of the dynamic wrist movements upon the median nerve for cases of idiopathic carpal tunnel syndrome. Background Carpal tunnel syndrome is the most common entrapment neuropathy and need to get better diagnosis especially for equivocal or mild degree cases for better patient outcome. Materials and methods 55 patients who diagnosed as idiopathic carpal tunnel syndrome by nerve conduction studies and 25 control group undergoing dynamic wrist ultrasound examination for cross sectional area of median nerve, its shape and carpal tunnel inlet as well as outlet areas. Results Cross sectional area inlet p value, sensitivity, specificity, PPV and NPV was <0.001, 88%, 100%, 100%, 80.6 for extension and flexion. Cross sectional area outlet p value, sensitivity, specificity, PPV and NPV was 0.038, 92%, 100%, 100%, 86.2 for extension and flexion. Cross sectional area inlet when compared with Cross sectional area outlet at different dynamic positions shows significant p value < 0.001. Conclusion Dynamic wrist ultrasound adds significant value in assessment of idiopathic carpal tunnel syndrome which can support the mild cases of electrophysiological nerve conduction studies.