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Updated: Jan 12, 2026
Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Diagnostic Accuracy of Neuromuscular Ultrasound for Carpal Tunnel Syndrome: A Real-World Study
Ujjawal Roy1, Michael S Cartwright2, Achal Kumar Srivastava3
1Department of Neurology, Roy Neuro Care Centre, Ranchi, India.
Background And Purpose:
To determine the diagnostic accuracy of median nerve ultrasound in suspected cases of carpal tunnel syndrome (CTS) in a prospective, real-world study.
Methods:
This prospective study was carried out over one year at Roy Neuro Care Centre, Ranchi, Jharkhand, India. The clinical, electrophysiologic, and ultrasonographic findings in suspected cases of CTS were collected. A history and physical examination consistent with CTS were considered the gold standard for diagnosis.
Results:
A total of 134 patients with symptoms suggestive of CTS were enrolled, and both wrists were examined. The diagnostic accuracy of various ultrasound parameters including maximum cross-sectional area (CSA) of the median nerve in the tunnel, difference between CSA at the level of the pronator quadratus compared to the carpal tunnel, and wrist-to-forearm ratio were evaluated by individual, parallel, and serial testing strategies using optimal cut-off values determined by the Youden Index. Parallel testing provided the highest sensitivity, making it suitable for screening, whereas serial testing produced the highest overall accuracy.
Conclusion:
Median nerve ultrasound is an accurate diagnostic tool for CTS in a real-world setting.
