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Updated: Aug 5, 2026
Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Is needle examination always necessary in evaluation of carpal tunnel syndrome?
J M Balbierz1, A C Cottrell, W D Cottrell
1Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, USA.
Objective:
To investigate whether needle evaluation added any important clinical information to normal nerve conduction studies in the evaluation of carpal tunnel syndromes.
Design:
Retrospective review of electromyography (EMG) done with the referring diagnosis of possible carpal tunnel syndrome.
Setting:
Outpatients seen for EMG evaluation at one university hospital by a single electromyographer.
Patients:
Consecutive sample of possible carpal tunnel syndrome patients.
Interventions:
None.
Main Outcome Measure:
We determined whether needle examination was abnormal when nerve conduction studies were normal.
Results:
In patients in whom only carpal tunnel syndrome was suspected, normal nerve conduction studies predicted that EMG would be normal 89.8% of the time (p = .0494). Testing based on a larger sample size might increase the predictive value.
Conclusions:
There may be a subpopulation of patients referred for carpal tunnel syndrome who may be adequately evaluated by nerve conduction studies alone. Additional studies will help evaluate whether this is so.
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