Comparative study between physical examination, electroneuromyography and ultrasonography in diagnosing carpal tunnel syndrome ,

摘要

Objective:To evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard.Methods:In this cross-sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination.Results:Nocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7%–78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0%–100%); and electromyography, 98.6% (95% CI: 95.7%–100%). The presence of atrophy, abnormalities of the sense of touch and longer-duration symptoms increased the sensitivity of ultrasonography and physical examination.Conclusion:The sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination.