Role of conventional ultrasound and shear wave elastography of median nerve in diagnosis and differentiation of carpal tunnel syndrome severity in correlation with electrodiagnostic studies

Abstract Background The gold standard for CTS diagnosis is abnormalities on electrophysiologic testing in conjunction with specified symptoms. Electrophysiologic testing can also identify the severity of nerve injury. Aim of work Aimed to investigate how effective various ultrasonography and elastography parameters at diagnosing and grading the severity of carpal tunnel syndrome in correlation with the electrophysiological evaluation of the median nerve. Methods The study included 62 wrists, 31 CTS cases and 25 females. Thirty-one healthy adults served as control group. Eleven males (35.5%) and 20 females (64.5%) were included. All US examinations were done with the subjects sitting with their upper limbs relaxed on a pillow with forearm in supine position, and the fingers are semi-flexed. Ultrasound and elastography parameters were recorded. NCS was done by recording median nerve motor and sensory functions and then comparing median nerve versus radial and ulnar nerves if the previous recordings were normal to detect early starting cases. Results US and elastography can significantly diagnose CTS and detecting its severity (mild/moderate versus severe CTS). Conclusions It is noninvasive to examine the median nerve using ultrasound and shear wave elastography, highly sensitive diagnostic modality. It can significantly diagnose CTS and severity of CTS (in contrast to mild, moderate, and severe instances). Mixing high-resolution conventional B-mode US with shear wave ultrasound elastography of the median nerve may increase the diagnostic precision of CTS.