ULTRASONOGRAPHY FOR DIAGNOSING CARPAL TUNNEL SYNDROME: A META-ANALYSIS OF DIAGNOSTIC TEST ACCURACY

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. ACSA-I >= 9 mm(2) is the best single diagnostic criterion, with a diagnostic odds ratio of 40.4 (sensitivity 87.3%, specificity 83.3%). (E-mail: jming@mail.ncku.edu.tw) Crown Copyright (C) 2012 Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology.