TITLE:
Combined Median Score Increasing Sensitivity of Carpal Tunnel Syndrome Diagnosis
AUTHORS:
Conor P. O’Brien
KEYWORDS:
Carpal Tunnel Syndrome, Ultrasound, Median Nerve, Combined Sensory In-dex, Combined Median Score
JOURNAL NAME:
World Journal of Neuroscience,
Vol.12 No.3,
August
9,
2022
ABSTRACT: Carpal tunnel syndrome (CTS) is the most common of all
focal neuropathies. Electrodiagnostic (EXD) of CTS has advanced to include Combined
Sensory Indexes (CSI) improving the specificity and sensitivity of EXD by employing
intra-hand comparative data. Ultrasound (US) is a popular tool for the assessment
of CTS. Cross Sectional Area (CSA) is the most consistent US parameter, but as a
single test, it has a similar false negative profile to EXD. This study describes
a dual method of CTS interrogation by EXD and US with the results applied to a single numerical score; the Combined
Median Score (CMS). This is the product of CSA of median nerve at Carpal
Tunnel inlet and CSI. In a series of 100 suspected cases, standard EDX identified
89 positive cases, CSI identified 92 positives,
CMS identified 95 positives. This new method further reduced the false negative
rate in CTS.