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http://hdl.handle.net/10362/184527
Título: | Diagnosis of carpal tunnel syndrome with ultrasound |
Autor: | Fontes, Tomás Sepriano, Alexandre Ramiro, Sofia Moniz, Paula Furtado, Carolina Figueiredo, Guilherme Falcão, Sandra |
Palavras-chave: | Classification Inflammation Ultrasonography Rheumatology Immunology and Allergy Immunology |
Data: | 28-Mai-2025 |
Resumo: | OBJECTIVES: To assess the value of adding the ultradistal level to other more thoroughly studied levels of the carpal tunnel when measuring the cross-sectional area (CSA) of the median nerve (MN) by ultrasound (US) in diagnosing patients with primary carpal tunnel syndrome (CTS). METHODS: Patients clinically diagnosed with primary CTS and healthy controls were included. The MN-CSA was measured by US at three wrist levels: proximal, distal and ultradistal. The best cut-off to differentiate cases and controls was determined for the CSA and for the difference between levels of the same wrist. The performance of different definitions for US-CTS compared with the clinical diagnosis of CTS was evaluated: (1) CSA above cut-off at each level; (2) CSA-difference above cut-off at each level; (3) ≥1 level with CSA above cut-off and (4) ≥1 CSA-difference above cut-off. Definition 3, excluding the ultradistal level, and combinations of definitions were also tested. RESULTS: In total, 219 patients and 39 controls were included. The CSA was higher in patients (10.5-16.8 mm2) than controls (6.2-7.6 mm2). The difference between groups was maximal at the ultradistal level (right: 10.1 mm2; left: 8.3 mm2). The CSA cut-offs were 11 mm2, 9 mm2 and 10 mm2 at the right, and 10 mm2, 8 mm2 and 10 mm2 at the left, for the proximal, distal and ultradistal levels, respectively. Definition 3 yielded the best balance between sensitivity (98%) and specificity (95%) (right hand). Removing the ultradistal level from definition 3 decreased sensitivity to 90%, maintaining the same specificity. CONCLUSIONS: Adding the ultradistal level improves the performance of US for diagnosing CTS. We suggest adding it in clinical practice when investigating CTS. |
Descrição: | Publisher Copyright: © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. |
Peer review: | yes |
URI: | http://hdl.handle.net/10362/184527 |
DOI: | https://doi.org/10.1136/rmdopen-2025-005563 |
ISSN: | 2044-6055 |
Aparece nas colecções: | NMS: iNOVA4Health - Artigos em revista internacional com arbitragem científica |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
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e005563.full.pdf | 777,76 kB | Adobe PDF | Ver/Abrir |
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