Painless, Less Expensive Way to Diagnose Carpal Tunnel Syndrome

Newswise — Ultrasound may be a promising alternative for the diagnosis and evaluation of patients who show symptoms of carpal tunnel syndrome, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Orlando, Florida.

Carpal tunnel syndrome is most often diagnosed using electromyography, whereby the delay in nerve conduction across the carpal tunnel is assessed using electric stimuli, a procedure that is often uncomfortable, even painful, as well as costly for patients. To assess the viability of ultrasound, which uses sound waves to create images, as a tool for diagnosing and treating carpal tunnel syndrome, an ultrasound examination of the wrist was conducted on 78 patients with carpal tunnel syndrome and 78 individuals in a control group. Both study groups completed self-administered questionnaires, and electromyography tests were conducted for the 78 patients. Similar results assessing the degree of nerve damage or destruction were found in all three diagnostic measures. In contrast to the other two tools, ultrasound was the only one able to determine the exact cause of the symptoms, whether it is inflammation in the tendon sheath pressing on the nerve, anatomical anomaly in the nerve itself or nerve compression from other cause. Based on the ultrasound results, the most appropriate treatment is considered, varying from the use of wrist splints, simple anti-inflammatory tablets or low dose steroids up to surgical options. In addition, ultrasound was shown to be a more reliable method for following response to therapy for the treatment of carpal tunnel syndrome.

"I believe it is time to say farewell to nerve conduction studies for assessment of patients suffering from carpal tunnel syndrome," said Yasser M. A. El Miedany, MD, Associate Professor, Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt, and lead investigator in the study. "Ultrasound examination should be strongly considered as a new, alternative diagnostic modality. In addition to being noninvasive and quick, it has high diagnostic accuracy and can define the cause of nerve compression. "

The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on the ACR's annual meeting, see http://www.rheumatology.org/annual.