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

Conservative Therapy for OA in the Fingers: A Literature Review

August 25, 2019

Beasley, J., Ward, L., Knipper-Fisher, K., Hughes, K., Lunsford, D., & Leiras, C. (2018). Conservative therapeutic interventions for osteoarthritic finger joints: A systematic review. Journal of Hand Therapy, 32. 153-164. The Skinny – The article reviews the evidence on the effectiveness of conservative treatment for those who experience osteoarthritis in fingers and in their finger…

Read More

Is HEP Just as Good as Therapy for Metacarpal Fracture Rehab?

July 7, 2019

Gülke, J., Leopold, B., Grözinger, D., Drews, B., Paschke, S., & Wachter, N. J. (2018). Postoperative treatment of metacarpal fractures – Classical physical therapy compared with a home exercise program. Journal of Hand Therapy, 31(1), 20-28. The Skinny – Medicine is moving towards a model that encourages less direct intervention and a more DIY focus…

Read More

How To Do A Fast but Thorough Hand Therapy Evaluation

March 22, 2019

We don’t get a lot of time. Sometimes new patients come in unexpectedly or someone comes at the wrong time and your 1 hour block for an eval is suddenly only 30 minutes. Do you know how to get the most out of your eval time with the patient? Do you know what things are…

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.