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Effectiveness of ultrasonography and nerve conduction studies in the diagnosing of carpal tunnel syndrome: clinical trial on accuracy.
Pimentel, Benedito Felipe Rabay; Faloppa, Flávio; Tamaoki, Marcel Jun Sugawara; Belloti, João Carlos.
Afiliação
  • Pimentel BFR; Division of Hand Surgery and Upper Limb, Discipline of Orthopaedics and Traumatology, Paraiba Valley Regional Hospital and Taubaté University Hospital, University of Taubaté, 239 Francisco de Barros, Taubaté, São Paulo, zip code 12020-230, Brazil. befecil@gmail.com.
  • Faloppa F; Division of Hand Surgery and Upper Limb, Department of Orthopedics and Traumatology, Federal University of São Paulo, Paulista School of Medicine, 786 Borges Lagoa, São Paulo, São Paulo, zip code 04038-030, Brazil.
  • Tamaoki MJS; Division of Hand Surgery and Upper Limb, Department of Orthopedics and Traumatology, Federal University of São Paulo, Paulista School of Medicine, 786 Borges Lagoa, São Paulo, São Paulo, zip code 04038-030, Brazil.
  • Belloti JC; Division of Hand Surgery and Upper Limb, Department of Orthopedics and Traumatology, Federal University of São Paulo, Paulista School of Medicine, 786 Borges Lagoa, São Paulo, São Paulo, zip code 04038-030, Brazil.
BMC Musculoskelet Disord ; 19(1): 115, 2018 04 12.
Article em En | MEDLINE | ID: mdl-29649998
BACKGROUND: The aim of this study was to evaluate the effectiveness of two diagnostic tests routinely used for diagnosing carpal tunnel syndrome (CTS)-ultrasonography (US) and nerve conduction studies (NCS)-by comparing their accuracy based on surgical results, with the remission of paresthesia as the reference standard. METHODS: We enrolled 115 patients, all of the female gender with a high probability of a clinical diagnosis of CTS. All patients underwent US and NCS for a diagnosis and subsequent surgical treatment. As a primary outcome, the accuracy of the US and NCS diagnoses was measured by comparing their diagnoses compared with those determined by the surgical outcomes. Their accuracy was secondarily evaluated based on before and after scores of the Boston Carpal Tunnel Questionnaire (BCTQ). RESULTS: Overall, 104 patients (90.4%) were diagnosed with CTS by the surgical reference standard, 97 (84.3%) by NCS, and 90 (78.3%) by US. The concordance of NCS and surgical treatment (p < 0.001; kappa = 0.648) was superior to that of US and surgical treatment (p < 0.001; kappa = 0.423). The sensitivity and specificity of US and NCS were similar (p = 1.000 and p = 0.152, respectively: McNemar's test). The BCTQ scores were lower after surgery in patients diagnosed by both US and NCS (p < 0.001and p < 0.001, respectively: analysis of variance). CONCLUSIONS: US and NCS effectively diagnosed CTS with good sensitivity but were not effective enough to rule out a suspicion of CTS. TRIAL REGISTRATION: This study was registered at September, 10 th, 2015, and the registration number was NCT02553811 .
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Túnel Carpal / Técnicas de Diagnóstico Neurológico Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Túnel Carpal / Técnicas de Diagnóstico Neurológico Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido