BACKGROUND Carpal tunnel syndrome (CTS) is the commonest entrapment neuropathy. The aim of this study was to assess the accuracy and validity of high resolution musculoskeletal ultrasound (US) in the diagnosis of CTS in the Saudi population. METHODS Sixty patients were diagnosed clinically to have CTS involving 89 wrists that were confirmed by neurophysiologic studies. Each affected wrist was characterized as idiopathic or associated with either diabetes mellitus or hypothyroidism and were assigned a severity grade based on results of neurophysiologic studies. Seventy-six healthy wrists from fifty age, sex and BMI matched healthy subjects were included in the control group. High resolution ultrasound (US) was performed to assess median nerve cross sectional area distal (CSAd) at the entry to the carpal tunnel and proximally (CSAp) at the level of pronator quadratus muscle with a further calculation of their difference (ΔCSA) and their mean average or CSAd+CSAp/2 (CSApd). RESULTS There was a significant difference between both groups regarding mean ± SD of CSAd, CSAp, ∆CSA, and CSApd (p = 0.0001). A positive significant correlation was also found between the CSAd, ∆ CSA and the CSApd measurements with neurophysiologic severity grade of CTS (P = 0.001). A ∆CSA threshold of 2.5 mm2 showed the highest sensitivity and specificity to diagnose CTS in Saudis. CONCLUSION High resolution ultrasound is a valid and accurate diagnostic modality in carpal tunnel syndrome and correlated to CTS severity. A ∆CSA greater than 2.5 mm2 is considered a valid diagnostic value for CTS in our Saudi population. CTS in our patients with diabetes tend to have greater median nerve US measurement values.

中文翻译：

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超声在不同病因的腕管综合征中的诊断潜力：超声中线神经测量与电诊断严重性的相关性。

背景技术腕管综合症（CTS）是最常见的压迫性神经病。这项研究的目的是评估高分辨率肌肉骨骼超声（US）在沙特阿拉伯人群CTS诊断中的准确性和有效性。方法60例临床诊断为CTS的患者，涉及89个腕部，并通过神经生理学研究证实。每个受影响的手腕均被定性为特发性或与糖尿病或甲状腺功能减退有关，并根据神经生理学研究结果确定严重程度。对照组包括来自五十个年龄，性别和与BMI相匹配的健康受试者的76个健康手腕。进行高分辨率超声（US）评估腕管入口处远端的中位神经横截面积（CSAd）和近端直肌水平的近端（CSAp），并进一步计算它们的差异（ΔCSA）和平均平均值或CSAd + CSAp / 2（CSApd）。结果两组之间CSAd，CSAp，∆CSA和CSApd的平均值±SD差异显着（p = 0.0001）。在CSAd，ΔCSA和CSApd测量值与CTS的神经生理学严重程度之间也发现正相关（P = 0.001）。∆CSA阈值为2.5 mm2，显示出在沙特阿拉伯诊断CTS的最高灵敏度和特异性。结论高分辨率超声是腕管综合症的一种有效而准确的诊断方法，并且与CTS的严重程度有关。∆CSA大于2。在我们的沙特人口中，5 mm2被认为是CTS的有效诊断值。在我们的糖尿病患者中，CTS倾向于具有更高的中位神经US测量值。