Ultrasonography for diagnosing carpal tunnel syndrome: a meta-analysis of diagnostic test accuracy |
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Authors: | Tai Ta-Wei Wu Cheng-Yi Su Fong-Chin Chern Tai-Chang Jou I-Ming |
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Institution: | Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. |
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Abstract: | Ultrasonography is widely used to diagnose carpal tunnel syndrome (CTS), a common peripheral neuropathy, but the reported diagnostic accuracy varies. This meta-analysis focused on the diagnostic test accuracy of ultrasonography for diagnosing CTS. Structured searches of PubMed for 1990-2010 were done and the data were extracted and meta-analyzed by pooling estimates of sensitivity, specificity, likelihood ratios and diagnostic odds ratios. Diagnostic performance was also judged by using a summary receiver operating characteristic curve. Twenty-eight trials involving 3995 wrists were included. A greater cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet (CSA-I) and a greater flattening ratio at the level of the hamate were seen in CTS wrists than in control wrists. A CSA-I ≥9 mm(2) is the best single diagnostic criterion, with a diagnostic odds ratio of 40.4 (sensitivity 87.3%, specificity 83.3%). |
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Keywords: | Carpal tunnel syndrome Median nerve Cross-sectional area Ultrasonography Meta-analysis Sensitivity Specificity Diagnostic accuracy |
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