Comparison of ultrasonographic parameters in the diagnosis of carpal tunnel syndrome in pregnancy

Abstract

Aims: The aim is to evaluate sonographic parameters in pregnant women diagnosed with carpal tunnel syndrome compared to electrodiagnostic tests, to determine whether these parameters have sufficient accuracy to allow their use in clinical practice. Methods: This retrospective study examines pregnant women aged 18-40 in the 3rd trimester who received a final diagnosis of carpal tunnel syndrome between 2021-2023 at Prof. Dr. Cemil Taşçıoğlu City Hospital. Pregnant women with symptomatic complaints were divided into two groups: those with positive electrodiagnostic test results indicating carpal tunnel syndrome and those with negative electrodiagnostic test results, forming the control group. All pregnant women participating in the study had their median nerve cross-sectional area, flexor carpi radialis, cross-sectional area, wrist-to-forearm ratio, and MN-CSA/FCR ratio (expressed as a percentage called NTR) values examined. Results: In pregnant women with carpal tunnel syndrome, the median nerve cross-sectional area values were observed to surpass those in the control cohort (10.06±3.24 vs. 7.84±2.52)(p<0.001). The wrist-to-forearm ratio in pregnant women with carpal tunnel syndrome (2.1±0.5) was statistically higher compared to the control group (1.0±0.1)(p<0.001). The NTR values in the pregnant women with carpal tunnel syndrome (CTS) were also higher than those in the control group (0.92±0.36 vs. 0.80±0.23) (p=0.036). The best cut-off for median nerve cross-sectional area values was calculated to be >8.6 mm². The best cut-off point for MN-CSA/FCR values was found to be >0.84%. The best cut-off for wrist-to-forearm ratio values was calculated as >1.4 mm². A receiver operating characteristic curve was generated, and the wrist-to-forearm ratio cut-off point of 1.4 showed a sensitivity of 97.1% and a specificity of 69.2%. Conclusion: Ultrasonography is useful in the diagnosis of pregnancy-related CTS. It has provided comparable results to electrodiagnostic tests and is additionally practical, cost-effective, and swift.

Keywords

• Carpal tunnel syndrome
• median nerve cross-sectional area
• electrodiagnostic tests

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