Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(01): 069-073
DOI: 10.1055/s-0040-1713390
Artigo Original
Mão

Is There an Association between Electroneuromyography and Ultrasound in the Diagnosis of Carpal Tunnel Syndrome?[*]

Article in several languages: português | English
Henver Ribeiro Paiva Filho 
1   Serviço de Cirurgia da Mão, Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Bruno Adriano Borges Elias 
1   Serviço de Cirurgia da Mão, Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Marlus Sérgio Borges Salomão Junior 
1   Serviço de Cirurgia da Mão, Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Valdênia Graças Nascimento Paiva 
1   Serviço de Cirurgia da Mão, Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Elias Felix Oliveira 
1   Serviço de Cirurgia da Mão, Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Murilo Antônio Rocha 
1   Serviço de Cirurgia da Mão, Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective To verify whether there is an association between the results of the severity in electroneuromyography and the positivity in ultrasound in the diagnosis of carpal tunnel syndrome.

Methods Sixty-eight patients were included in the study, 61 women and 7 men, with a mean age of 54.4 years. The ultrasound results (positive or negative) were crossed with the results of electroneuromyography (mild, moderate or severe), and the existence of association was verified.

Results One hundred and thirty-six hands with suspicion or symptoms of carpal tunnel syndrome were evaluated. Positive ultrasound diagnosis was observed in 72 hands and negative in 64; 123 hands presented positive electroneuromyography for carpal tunnel syndrome, and there were 13 negative results. The severe degree in electroneuromyography was prevalent.

Conclusion There was a statistically significant association between electroneuromyography and ultrasonography (p < 0.05), and ultrasound positivity was higher for more severe levels of carpal tunnel syndrome given by electroneuromyography.

Keywords

electroneuromyography - compressive neuropathy - carpal tunnel syndrome - ultrasonography

* Work done in the Orthopedics and Traumatology Service, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.




Publication History

Received: 26 August 2019

Accepted: 17 March 2020

Article published online:
09 October 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999; 282 (02) 153-158
    CrossrefPubMedGoogle Scholar
  • 2 Wang WL, Buterbaugh K, Kadow TR, Goitz RJ, Fowler JR. A Prospective Comparison of Diagnostic Tools for the Diagnosis of Carpal Tunnel Syndrome. J Hand Surg Am 2018; 43 (09) 833-836.e2
    CrossrefPubMedGoogle Scholar
  • 3 Sears ED, Swiatek PR, Hou H, Chung KC. Utilization of Preoperative Electrodiagnostic Studies for Carpal Tunnel Syndrome: An Analysis of National Practice Patterns. J Hand Surg Am 2016; 41 (06) 665-672.e1
    CrossrefPubMedGoogle Scholar
  • 4 Buchberger W, Schön G, Strasser K, Jungwirth W. High-resolution ultrasonography of the carpal tunnel. J Ultrasound Med 1991; 10 (10) 531-537
    CrossrefPubMedGoogle Scholar
  • 5 Kerasnoudis A, Tsivgoulis G. Nerve Ultrasound in Peripheral Neuropathies: A Review. J Neuroimaging 2015; 25 (04) 528-538
    CrossrefPubMedGoogle Scholar
  • 6 Simon NG, Talbott J, Chin CT, Kliot M. Peripheral nerve imaging. Handb Clin Neurol 2016; 136: 811-826
    CrossrefPubMedGoogle Scholar
  • 7 Hobson-Webb LD, Padua L. Ultrasound of Focal Neuropathies. J Clin Neurophysiol 2016; 33 (02) 94-102
    CrossrefPubMedGoogle Scholar
  • 8 Fowler JR, Cipolli W, Hanson T. A Comparison of Three Diagnostic Tests for Carpal Tunnel Syndrome Using Latent Class Analysis. J Bone Joint Surg Am 2015; 97 (23) 1958-1961
    CrossrefPubMedGoogle Scholar
  • 9 Wee TC, Simon NG. Ultrasound elastography for the evaluation of peripheral nerves: A systematic review. Muscle Nerve 2019; 60 (05) 501-512
    CrossrefPubMedGoogle Scholar
  • 10 Kirkwood BR, Sterne JA. Essential medical statistics. 2nd ed. Massachusetts, USA: Blackwell Science; 2006
    Google Scholar
  • 11 Fleiss JL. The design and analysis of clinical experiments. New York: Wiley; 1986
    Google Scholar
  • 12 Mondelli M, Giannini F, Giacchi M. Carpal tunnel syndrome incidence in a general population. Neurology 2002; 58 (02) 289-294
    CrossrefPubMedGoogle Scholar
  • 13 Sassi SA, Giddins G. Gender differences in carpal tunnel relative cross-sectional area: a possible causative factor in idiopathic carpal tunnel syndrome. J Hand Surg Eur Vol 2016; 41 (06) 638-642
    CrossrefPubMedGoogle Scholar
  • 14 Lakshminarayanan K, Shah R, Li ZM. Sex-related differences in carpal arch morphology. PLoS One 2019; 14 (05) e0217425
    CrossrefPubMedGoogle Scholar
  • 15 Bower JA, Stanisz GJ, Keir PJ. An MRI evaluation of carpal tunnel dimensions in healthy wrists: Implications for carpal tunnel syndrome. Clin Biomech (Bristol, Avon) 2006; 21 (08) 816-825
    CrossrefPubMedGoogle Scholar
  • 16 Brett AW, Oliver ML, Agur AM, Edwards AM, Gordon KD. Quantification of the transverse carpal ligament elastic properties by sex and region. Clin Biomech (Bristol, Avon) 2014; 29 (06) 601-606
    CrossrefPubMedGoogle Scholar
  • 17 Cobb TK, Dalley BK, Posteraro RH, Lewis RC. Anatomy of the flexor retinaculum. J Hand Surg Am 1993; 18 (01) 91-99
    CrossrefPubMedGoogle Scholar
  • 18 Barcenilla A, March LM, Chen JS, Sambrook PN. Carpal tunnel syndrome and its relationship to occupation: a meta-analysis. Rheumatology (Oxford) 2012; 51 (02) 250-261
    CrossrefPubMedGoogle Scholar
  • 19 Harris-Adamson C, Eisen EA, Kapellusch J. et al. Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers. Occup Environ Med 2015; 72 (01) 33-41
    CrossrefPubMedGoogle Scholar
  • 20 Tai TW, Wu CY, Su FC, Chern TC, Jou IM. Ultrasonography for diagnosing carpal tunnel syndrome: a meta-analysis of diagnostic test accuracy. Ultrasound Med Biol 2012; 38 (07) 1121-1128
    CrossrefPubMedGoogle Scholar
  • 21 Özçakar L, Kara M, Chang KV. et al. Nineteen reasons why physiatrists should do musculoskeletal ultrasound: EURO-MUSCULUS/USPRM recommendations. Am J Phys Med Rehabil 2015; 94 (06) e45-e49
    CrossrefPubMedGoogle Scholar
  • 22 Horng YS, Chang HC, Lin KE, Guo YL, Liu DH, Wang JD. Accuracy of ultrasonography and magnetic resonance imaging in diagnosing carpal tunnel syndrome using rest and grasp positions of the hands. J Hand Surg Am 2012; 37 (08) 1591-1598
    CrossrefPubMedGoogle Scholar
  • 23 Mhoon JT, Juel VC, Hobson-Webb LD. Median nerve ultrasound as a screening tool in carpal tunnel syndrome: correlation of cross-sectional area measures with electrodiagnostic abnormality. Muscle Nerve 2012; 46 (06) 871-878
    CrossrefPubMedGoogle Scholar
  • 24 Abrishamchi F, Zaki B, Basiri K, Ghasemi M, Mohaghegh M. A comparison of the ultrasonographic median nerve cross-sectional area at the wrist and the wrist-to-forearm ratio in carpal tunnel syndrome. J Res Med Sci 2014; 19 (12) 1113-1117
    PubMedGoogle Scholar