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

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.

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