ABSTRACT
Diagnostic tests in patients complaining of carpal tunnel syndrome (CTS) are based
on physical examination, electrodiagnostic tests (EDTs), and diagnostic imaging. Timely
diagnosis helps prevent permanent nerve damage and its sequelae in terms of functional
impairment. Imaging provides additional information to that obtained from clinical
tests and EDTs. By allowing direct visualization of the compressed median nerve (MN),
ultrasound (US) and magnetic resonance imaging can depict the causes for secondary
CTS and describe anatomical variants, such as a bifid MN or a persistent median artery
of the forearm, as well as space-occupying lesions including tenosynovitis and ganglion
cysts. In addition, diagnostic imaging is of value for postoperative patients presenting
with persistent symptoms. Finally, US is able to add information for EDT-negative
symptomatic patients. Over time, US has increased in its sensitivity and specificity
so it can be used as the initial test in patients presenting with clinical symptoms
of CTS because it is now equivalent to EDT. The use of US as a screening test may
reduce the number of EDT examinations in patients with suspected CTS, providing additional
valuable anatomical information.
KEYWORDS
Carpal tunnel - ultrasound - sonography - magnetic resonance imaging - electroneurography
- ultrasound guidance
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Andrea S KlauserM.D.
Department of Diagnostic Radiology, Anichstrasse 35
Medical University Innsbruck, 6020 Innsbruck, Austria
Email: andrea.klauser@i-med.ac.at