Abstract
Carpal tunnel syndrome (CTS), the most common mononeuropathy, results from compression
of the median nerve within the fibro-osseous carpal tunnel. Diagnosis is typically
based on clinical evaluation and confirmed by nerve conduction studies. However, ultrasound
(US) has emerged as a valuable noninvasive adjunct for CTS confirmation, offering
potential advantages over electrodiagnostic testing in terms of patient comfort and
diagnostic accuracy. This review begins with a concise summary of carpal tunnel anatomy
and CTS pathophysiology as a foundation for exploring the diverse applications of
US in CTS evaluation. B-mode US assessment is presented with a focus on cross-sectional
imaging and dynamic evaluations, including the transverse translocation and longitudinal
gliding of the median nerve. We also review current methods for assessing vascularization
in CTS and explore the usefulness of elastography in CTS evaluation. The advantages
and limitations of each US method are elucidated, highlighting their practical utility
in clinical practice.
Keywords carpal tunnel syndrome - cross-sectional ultrasound - dynamic ultrasound - superb
microvascular imaging - elastography
