Effectiveness of ultrasonography and nerve conduction studies in the diagnosing of carpal tunnel syndrome: clinical trial on accuracy
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Data
2018
Autores
Pimentel, Benedito Felipe Rabay 
Faloppa, Flávio
Tamaoki, Marcel Jun Sugawara
Belloti, Joao Carlos
Tipo
Artigo
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Título de Volume
Resumo
Background: The aim of this study was to evaluate the effectiveness of two diagnostic tests routinely used for diagnosing carpal tunnel syndrome (CTS)-ultrasonography (US) and nerve conduction studies (NCS)-by comparing their accuracy based on surgical results, with the remission of paresthesia as the reference standard. Methods: We enrolled 115 patients, all of the female gender with a high probability of a clinical diagnosis of CTS. All patients underwent US and NCS for a diagnosis and subsequent surgical treatment. As a primary outcome, the accuracy of the US and NCS diagnoses was measured by comparing their diagnoses compared with those determined by the surgical outcomes. Their accuracy was secondarily evaluated based on before and after scores of the Boston Carpal Tunnel Questionnaire (BCTQ). Results: Overall, 104 patients (90.4%) were diagnosed with CTS by the surgical reference standard, 97 (84.3%) by NCS, and 90 (78.3%) by US. The concordance of NCS and surgical treatment (p < 0.001
kappa = 0.648) was superior to that of US and surgical treatment (p < 0.001
kappa = 0.423). The sensitivity and specificity of US and NCS were similar (p = 1.000 and p = 0.152, respectively: McNemar's test). The BCTQ scores were lower after surgery in patients diagnosed by both US and NCS (p < 0.001and p < 0.001, respectively: analysis of variance). Conclusions: US and NCS effectively diagnosed CTS with good sensitivity but were not effective enough to rule out a suspicion of CTS.
kappa = 0.648) was superior to that of US and surgical treatment (p < 0.001
kappa = 0.423). The sensitivity and specificity of US and NCS were similar (p = 1.000 and p = 0.152, respectively: McNemar's test). The BCTQ scores were lower after surgery in patients diagnosed by both US and NCS (p < 0.001and p < 0.001, respectively: analysis of variance). Conclusions: US and NCS effectively diagnosed CTS with good sensitivity but were not effective enough to rule out a suspicion of CTS.
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Citação
Bmc Musculoskeletal Disorders. London, v. 19, p. -, 2018.