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
Therapeutic Interventions and Contraindications of Cupping
By Kaylen Kallander Cupping therapy is used to apply negative pressure to a localized area of muscular or neurological pain to relieve nerve pressure and increase blood flow to an affected area. This modality is commonly used for athletes, but is also a frequent treatment in physical therapy, occupational therapy, or hand therapy. While cupping…
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…
Does mirror therapy work for hand therapy patients with general orthopedic conditions?
By: Maddie Mott Rostami, R. H., Arefi, A., & Tabatabaei, S. (2013). Effect of mirror therapy on hand function in patients with hand orthopaedic injuries: a randomized controlled trial. Disability and Rehabilitation, 35(19). 1647-1651. DOI: 10.3109/09638288.2012.751132 The Skinny: How does mirror therapy work? Mirror therapy (MT) is performed by placing the patient’s injured extremity into…
How to Improve Fine Motor Translation Skills
By: Josh MacDonald The Basics – I lay a pile of small objects on the table and an open container for the client to put them into. What object I use depends on the client’s level. We’ll get to that later. Then, they use a 2-point pincer grasp to pick up one and shift it…
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.