THE SENSITIVITY AND SPECIFICITY OF ULTRASOUND FOR THE DIAGNOSIS OF CARPAL TUNNEL SYNDROME: A META-ANALYSIS

Fowler, J. R., Gaughan J. P., & Ilyas, A.M. (2011).  The sensitivity and specificity of ultrasound for the diagnosis of carpal tunnel syndrome: A meta-analysis.  Clinical Orthopedics and Related Research, 469(4), 1089-1094.

The Skinny –The authors sought out to determine the sensitivity and specificity of ultrasound therapy for the diagnosis of carpal tunnel syndrome using three scenarios. 1.) using all studies regardless of reference standard 2.) using all studies with electrodiagnostic as the reference standards and 3.)  using all studies with clinical diagnosis as the gold standard. 

In the Weeds – The authors found a total of 19 articles that were included in the review.   Remember, sensitivity indicates a true positive rate and specificity indicates a true-negative rate. 

They found the sensitivity and specificity of ultrasound was 77.6% (71.6%-83.6%) and 86.8% (78.9%-94.8%), respectively. 

They found the sensitivity and specificity of electrodiagnostic testing to be 80.2% (71.3-89.0) and 78.7% (66.4-91.1, respectively).

Bringing it Home– Ultrasound showed a higher specificity but electrodiagnostic had a slightly higher sensitivity.  Although ultrasound may not replace electrodiagnostic testing as the most sensitive tool for diagnosing carpal tunnel, it may be a feasible alternative to electrodiagnostic testing as a first line confirmatory test.

Overall a very nicely done study however it was not without its limitation.  There was a lack of heterogeneity among the studies reviewed.  Both, ultrasound and electrodiagnostic testing it very operator dependent. The upside of ultrasound is it can be performed very quickly, it is often less expensive, and off course it is essentially pain-free. 

Leave a Comment






More To Read

Assessments Seen in the Hand Therapy World 

May 15, 2022

By: Dalton Busch  Below I have created a list of some of the common assessments that are seen in the hand therapy world. Keep in mind that this list is not inclusive of all the assessments you might come across in this setting. With each assessment, I describe what it is, who the assessment is…

Read More

Extensor Tendon Repair Protocol (zone 4-7): Immediate Controlled Active Motion (ICAM)

December 8, 2019

Howell, J.W., Merritt, W. H., & Robinson, S. J. (2005). Immediate Controlled Active Motion Following Zone 4–7 Extensor Tendon Repair. Journal of hand therapy: 18, 182-90. The Skinny- For years immobilization was the standard procedure following extensor tendon injuries in zones 4-7. As expected immobilization caused lengthy rehabilitation times, stiff joints, and tendon adhesions often…

Read More

How much pain should a patient have during and after therapy?

February 9, 2020

How much pain should a patient have during and after therapy? As we all know pain is somewhat subjective.  It can be hard to determine how much pain a patient should experience with the type of injury as well as the type of therapy intervention and hand pain treatment.  The saying of “no pain, no…

Read More
Envelope_1

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.