THE SENSITIVITY AND SPECIFICITY OF ULTRASOUND FOR THE DIAGNOSIS OF CARPAL TUNNEL SYNDROME: A META-ANALYSIS
Filed under Diagnoses
Fowler, J. R., Gaughan J. P., & Ilyas, A.M. (2011). The sensitivity and specificity of ultrasound for the diagnosis of carpal tunnel syndrome: A meta-analysis. Clinical Orthopedics and Related Research, 469(4), 1089-1094.
The Skinny –The authors sought out to determine the sensitivity and specificity of ultrasound therapy for the diagnosis of carpal tunnel syndrome using three scenarios. 1.) using all studies regardless of reference standard 2.) using all studies with electrodiagnostic as the reference standards and 3.) using all studies with clinical diagnosis as the gold standard.
In the Weeds – The authors found a total of 19 articles that were included in the review. Remember, sensitivity indicates a true positive rate and specificity indicates a true-negative rate.
They found the sensitivity and specificity of ultrasound was 77.6% (71.6%-83.6%) and 86.8% (78.9%-94.8%), respectively.
They found the sensitivity and specificity of electrodiagnostic testing to be 80.2% (71.3-89.0) and 78.7% (66.4-91.1, respectively).
Bringing it Home– Ultrasound showed a higher specificity but electrodiagnostic had a slightly higher sensitivity. Although ultrasound may not replace electrodiagnostic testing as the most sensitive tool for diagnosing carpal tunnel, it may be a feasible alternative to electrodiagnostic testing as a first line confirmatory test.
Overall a very nicely done study however it was not without its limitation. There was a lack of heterogeneity among the studies reviewed. Both, ultrasound and electrodiagnostic testing it very operator dependent. The upside of ultrasound is it can be performed very quickly, it is often less expensive, and off course it is essentially pain-free.
–
More To Read
Sensitivity and Specificity in Thoracic Outlet Syndrome (TOS) Tests in Hand Therapy
By: Mikayla Murphy Sensitivity and Specificity in Thoracic Outlet Syndrome (TOS) Tests in Hand Therapy Thoracic outlet syndrome (TOS) describes the compression of nerves, arteries, and veins as they pass through the thoracic outlet. Compression can occur at the interscalene triangle, the costoclavicular triangle, and the subcoracoid space (Physiopedia, n.d.). There are three types of…
Simple but Effective Ways Hand Therapists Address Psychosocial Impacts of Upper Extremity Injuries
Although psychosocial factors are often not formally assessed during an evaluation in those with upper extremity injuries, the therapist often informally assesses these during and after treatment sessions. Sustaining an upper extremity injury can be a physically and emotionally challenging experience. Beyond the physical pain and limitations, these injuries can profoundly impact an individual’s psychosocial…
Sensory Processing in People With and Without Tendinopathy
Emilee Sanders, OTS Sensory Processing in People With and Without Tendinopathy: A Systematic Review With Meta-analysis of Local, Regional, and Remote Sites in Upper- and Lower-Limb Conditions Rio, E, Sandler, J., Cheng, K., Moseley, G. L., Cook, J., & Girdwood, M. (2021) Sensory processing in people with and without tendinopathy: A systematic review with meta-analysis…
Pain management techniques for Wrist Fractures
Pain management techniques for wrist fractures Distal radius fractures account for 17.5% of all fractures with a median age of 60.23(Candela et.al, 2022). Pain management is a significant part of post wrist fracturetreatment due to limitations that pain incurs. Chronic Regional Pain Syndrome (CRPS) canoccur along with a distal radius fracture but will not be…
Sign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.