Value of Comparing Wrist and Forearm Cross-sectional Area Measurements of the Median Nerve in Diagnosing CTS versus Electrophysiological Studies

Abstract

n recent years, decompression of the median nerve has become one of the most frequently performed surgical procedure with estimated 600,000 procedures done annually (Smetana et al., 2016). There is a big artillery of diagnostic tests that can be used to verify or exclude such affliction. Those tests including clinical history, provocative tests, diagnostic scales as well as the NCS with the latest addition of the ultrasonography. The literature continues to provide variable accountability to the sensitivity and specificities of those tests with no definite consensus regarding the best diagnostic criteria. With such a high reported incidence of CTS, it is clear that an accurate and efficient diagnostic protocol would have significant health care as well as financial implications (Prime et al., 2010). According to the latest guidelines of the American academy of orthopedic surgery (AAOS), there is no strong evidence that history taking and clinical tests can be used alone reliably to diagnose carpal tunnel syndrome (AAOS, 2016). The NCS have largely been considered the gold standard diagnostic tool and for long the neurophysiological confirmation of the clinical diagnosis was considered mandatory. The value of NCS for CTS diagnosis is currently challenged by the demonstration of the fallacies of different