Document Type : Original Article
Authors
1
Trauma Research Center, Department of orthopedics, Shahid Sadoughi hospital, school of medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2
Department of radiology School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3
Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4
Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5
Department of Orthopedic Surgery, Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
10.22034/ijos.2026.246025
Abstract
Introduction: Carpal tunnel syndrome (CTS) represents the most prevalent form of compressive neuropathy. Although electrodiagnostic assessments (EMG–NCV) are routinely used for diagnosis and demonstrate good accuracy, they are invasive procedures and can sometimes produce false‑negative outcomes. In recent years, high‑resolution ultrasonography has gained attention as a noninvasive, widely available, and cost‑efficient diagnostic option. The purpose of this study was to investigate the usefulness of sonographic evaluation in diagnosing CTS and to examine how its findings relate to clinical symptoms and electrophysiological results.
Materials & Methods: In this cross‑sectional diagnostic study, individuals with a clinical suspicion of carpal tunnel syndrome were assessed. Each participant underwent both EMG–NCV testing and bilateral wrist ultrasonography. Sonographic variables, including the cross‑sectional area (CSA) and the width of the median nerve at various points along the forearm and within the carpal tunnel, were compared among electrodiagnostic severity categories classified as normal, mild, moderate, and severe. The sensitivity and specificity were determined for chosen CSA and nerve‑width cutoff values.
Results & Discussion: 60 patients with the mean age of 49.5±10.4 years and mean BMI of 26.8±3.6 kg/m² being 90% female and 80% with bilateral involvement were studied. Age was not significantly associated with CTS severity (P=0.344), whereas higher BMI correlated with greater severity (P=0.01). Median nerve CSA width increased parallel with disease severity. In the right hand, a CSA cut off of 8.5 mm² at the carpal tunnel yielded 87.5% sensitivity and 81.7% specificity; in the left hand, a CSA cut off of 8 mm² provided 70% sensitivity and 95.5% specificity. Nerve width ≥ 5 mm showed high sensitivity but lower specificity.
Conclusion: Ultrasonography—especially assessing the cross‑sectional area of the median nerve—serves as a dependable, noninvasive, and precise complementary tool alongside EMG–NCV for both identifying and grading the severity of CTS.
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