Comparison of Accuracy of High-Resolution Ultrasound with Nerve Conduction Studies in Diagnosing Carpal Tunnel Syndrome

Background: Carpal Tunnel Syndrome (CTS) affects millions worldwide, causing hand pain, numbness, and weakness. Current diagnostic methods, like nerve conduction studies, have limitations. Recent data suggests high-resolution ultrasound offers comparable accuracy. With treatment options varying from conservative to surgical, precise diagnosis is essential. Ultrasound shows promise in improving diagnostic accuracy and patient outcomes. Objective: To determine the diagnostic accuracy of high resolution ultrasound in diagnosing carpal tunnel syndrome taking nerve conduction test as gold standard. Methods: The study obtained approval from the Hospital Ethical Board and enrolled 76 patients meeting selection criteria from Orthopedics, Neurosurgery, and Medicine OPD at the Department of Radiology, Sir Ganga Ram Hospital, Lahore. After obtaining consent and noting demographics, patients underwent wrist ultrasound using a 7.5MHz linear array transducer. The cross-sectional area of the median nerve at the carpal tunnel entrance was measured, categorizing patients by disease severity. Nerve conduction tests at Mayo Hospital determined sensory and motor fiber function. Results were categorized, confirming patients as positive or negative. Standard protocols were followed for patient management, and data were recorded in a proforma. Results: The mean age of patients in this study was 39.95±11.83 years, ranging from 20 to 60 years. Of the 76 participants, 39 (51.3%) were aged 20-40, and 37 (48.7%) were aged 41-60. Females comprised 59.2% of the population. Right side involvement was seen in 48.7%, and left side in 51.3%. The mean symptom duration was 31.67±7.55 months, with 55.3% having symptoms ≤ 30 months. High-resolution ultrasound detected carpal tunnel syndrome in 90.79%, with diagnostic accuracy of 98.70%. Conclusion: This study supports high-resolution ultrasound as an effective diagnostic tool for carpal tunnel syndrome, with strong sensitivity and specificity, suggesting its integration into clinical assessments for comprehensive diagnosis.