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

Which is better for DeQuervain’s: Splinting or Injection?

August 10, 2022

Rapid Review  Cavaleri, R., Schabrun, S. M., Te, M., & Chipchase, L. S. (2016). Hand therapy versus corticosteroid injections in de Quervain’s disease treatment: A systematic review and meta-analysis. Journal of hand therapy: official journal of the American Society of Hand Therapists, 29(1), 3–11. The Skinny: DeQuervain’s Tenosynovitis is a stenosing tenosynovial inflammation affecting the…

Read More

Splinting vs Stretching after a Stroke to treat Hand Spasticity

May 12, 2023

Splinting versus Stretching to improve hand function and reduce hand spasticity after stroke Reference: Ahmad Khan, M., & Singh, P. (2018, February). Effect of Hand Splinting versus Stretching Exercises for Reducing Spasticity and Improving Hand Function in Poststroke Hemiplegia: AComparative Interventional Study. Retrieved December 4, 2022, from -7706;year=2018;volume=50;issue=4;spage=125;epage=129;aulast=Khan The Skinny: A comparative study by Khan…

Read More

Increasing Shoulder Range of Motion by improving Scapulohumeral Rhythm

September 15, 2019

Scapulohumeral rhythm is often the key component when treating shoulder conditions and the reason for the lack of total shoulder range of motion. This may also be a critical component in order to prevent shoulder conditions during rehabilitation of other upper extremity conditions such as distal radius fractures, tendon injuries, and elbow injuries. Scapulohumeral rhythm…

Read More

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.