1. Exploring ultrasound and electromyography for carpal tunnel syndrome diagnosis: a comprehensive comparative study and implications for occupational medicine.
- Author
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Braham, Salem, Moussa, Amen, Bouhoula, Marwa, Ben Meriem, Nihel, Annen, Ichraf, Sakly, Ghazi, Chouchane, Asma, Ben Abdelkader, Malek, Aloui, Asma, Kacem, Imène, Maoua, Maher, Kalboussi, Houda, Elmaalel, Olfa, Mhabrech, Houda, Chatti, Souheil, and Brahem, Aicha
- Subjects
CARPAL tunnel syndrome ,DIAGNOSTIC ultrasonic imaging ,MEDIAN nerve ,OCCUPATIONAL medicine ,ULTRASONIC imaging - Abstract
Background: To assess the contribution of ultrasound in diagnosing occupational carpal tunnel syndrome (CTS), compare it with electromyography (EMG) results, and evaluate the ultrasound characteristics of CTS patients. Methods: A nine-month cross-sectional study (January–September 2021) involved CTS patients and a control group, utilizing a structured form for data collection. EMG was performed on the patient group ('cases') and ultrasound examinations were conducted on both groups. Statistical analysis was performed using SPSS software. Results: Among 44 cases and 30 controls, CTS patients (mean age 44.9 years) exhibited predominantly bilateral symptoms (90.9%). The optimal cross-sectional area (CSA) threshold for diagnosis was 10.3 mm
2 (89% sensitivity, 84% specificity). Significant differences in ultrasound criteria were observed between patient and control groups, including the "notch sign" (p = 0.012), hypoechoic appearance (p = 0.016), and reduced median nerve mobility (p = 0.021). Quantitatively, CSA (13.7 mm2 vs. 7.4 mm2 ), flattening ratio (3.3 vs. 2.1), and retinaculum bulging (3.2 mm vs. 1.9 mm) significantly differed between cases and controls (p = 0.0019, 0.025, and 0.01, respectively). Positive Phalen tests correlated with higher CSA (p = 0.005) and retinacular bulging (p = 0.02). CSA correlated with EMG parameters, indicating slower conduction velocities, lower amplitudes, and longer latencies (p < 10^(−3), r = −0.56, −0.62, −0.36, and −0.68, respectively). Conclusion: This study highlights ultrasound's diagnostic potential for CTS, particularly in occupational settings. Its non-invasiveness and reliability advocate for its integration into routine diagnostic protocols, supporting evidence-based management strategies. Further research is needed to explore long-term efficacy and broader applicability. [ABSTRACT FROM AUTHOR]- Published
- 2024
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