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…
Phantom Limb Pain, Residual Limb Pain, & Phantom Limb Sensation: Which is Which?
Written by Melissa Miller Introduction After amputation, the majority of individuals will experience phantom limb pain (PLP), residual limb pain (RLP), and/or phantom limb sensation (PLS). Experiencing these pains or sensations can greatly disrupt an individual’s quality of life. It is important to know what each of these are as each can impact the client…
Article Review: Best Edema Management Techniques in Hand Therapy
Miller, L. K., Jerosch-Herold, C., & Shepstone, L. (2017). Effectiveness of edema management techniques for subacute hand edema: a systematic review. Journal of Hand Therapy, 30(4), 432-446. doi: http://dx.doi.org/10.1016/j.jht.2017.05.011 By: Ammie Ingwaldson The Skinny Edema is something therapists deal with on a daily basis and often is apart of most treatments. Managing edema can be a challenge…
Common Median Nerve Injuries
Common Median Nerve Injuries By: Madison Mott Did you know!? Aside from the most common upper extremity nerve compression, carpal tunnel syndrome (CTS), there are several additional median nerve injuries. Pronator SyndromeCompression of the median nerve between the two heads of pronator teres. Result of recurrent, forceful gripping, forearm rotation, or elbow flexion. Signs include…
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.