Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental Neurology2075-54732409-2533Research Center of Neurology22110.17816/psaic221UnknownElectromyography and ultrasound studies in the diagnostics of carpal tunnel syndromeNikitinS. S.nikitin-s@bk.ruMaslakA. A.nikitin-s@bk.ruKurenkovA. L.nikitin-s@bk.ruSavitskayaN. G.nikitin-s@bk.ruPripisnovaS. G.nikitin-s@bk.ruInstitute of General Pathology and Pathophysiology RAMSMedical Center of Ministry of Foreign AffairsResearch Center of Children’s Health RAMSResearch Center of Neurology RAMSCentral Institute of Traumatology and Orthopaedy, Ministry of Health0912201374202602022017Copyright © 2013, Nikitin S.S., Maslak A.A., Kurenkov A.L., Savitskaya N.G., Pripisnova S.G.2013<p>Carpal tunnel syndrome (CTS) is a clinical condition with sensoryand motor manifestations related to median nerve (MN)compression at the wrist level. The goal of this study was tocompare two diagnostics methods, electromyography (EMG)and ultrasound (US) examination, in establishing the mostreliable and precise diagnostic approach to CTS. We examined67 patients with clinical diagnosis of CTS and a control groupof 42 healthy volunteers. For EMG and US, sensitivity andspecificity parameters were calculated, and grading of theseverity of MN injury was assessed with these technologies.The sensitivity and specificity for EMG was 93% and 97%, andfor US, 85% and 73%, respectively. The severity grades of MNinjury defined by EMG and US did not correspond to eachother. According to our data, EMG has higher sensitivity comparedto US in the diagnosis of CTS. EMG also allows estimatingquantitatively the severity of MN injury, while USmethod shows predominantly some qualitative estimation ofMN injury in CTS.</p>carpal tunnel syndrometunnel neuropathy of median nerveultrasound examinationelectromyographydiagnosticsсиндром карпального каналатуннельная невропатия срединного нерва, ультразвуковое исследованиеэлектронейромиографиядиагностика[Аль-Замиль М.Х. Карпальный синдром. Клин. неврол. 2008; 1:41–45.][Берзиньш Ю.Э., Думбере Р.Т. Туннельные поражения нервов верхней конечности. Рига: Зинатне, 1989.][Жулев Н.М., Осетров Б.А., Жулев С.Н., Лалаян Т.В. Невропатии: руководство для врачей. Спб: СпБМАПО, 2005.][Кипервас И.П. Туннельные синдромы. М: Ньюдиамед, 2010.][Меркулова Д.М., Меркулов Ю.А., Никитин C.C. Туннельные невропатии. Диагностика и принципы патогенетической терапии. Consilium Med. 2012; 2: 1–2.][Altman D.G., Bland J.M. Diagnostic tests. 1: Sensitivity and specificity. BMJ 1994; 308: 1552.][Bong C.K., Kwang-lk J., Goo H.B. Comparison of sonography and electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. J. Hand Surgery 2008; 33: 65–68.][Daube J.R., Rubin D.I. Clinical neurophysiology–companion CD. 3d ed. NY: Oxford University Press, 2009.][Dong-Wook R., Sang Hee I., Seong-Kyun K. et al. Median nerve conduction study through the carpal tunnel using segmental nerve length measured by ultrasonographic and conventional tape methods. Phys. Med. Rehabilitation 2011; 92: 1–2.][Jablecki C.K., Andary M.T., Floeter M.K. et al. Second literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 2002; 25: 918–922.][Jablecki C.K., Andary M.T., So Y.T. et al. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 1993;16: 1392–1414.][Watson J.C. The electrodiagnostic approach to carpal tunnel syndrome. Neurol. Clinics 2012; 30: 460–461, 472.][Jillapalli D., Shefner J.M. Electrodiagnosis in common mononeuropathies and plexopathies. Semin. Neurol. 2005; 25: 196–203.][Mhoon J.T., Juel V.C., Hobson-Webb L.D. Median nerve ultrasound as a screening tool in carpal tunnel syndrome: correlation of cross-sectional area measures with electrodiagnostic abnormality. Muscle Nerve 2012; 46: 871.][Preston D.C., Shapiro B.E. Electromyography and neuromuscular disorders, clinical and electrophysiologic correlations. Boston: Butterworth-Heinemann, 1998.][Roll S.C., Case-Smith J., Evans K.D. Diagnostic accuracy of ultrasonography vs. electromyography in carpal tunnel syndrome: a systematic review of literature. Ultrasound Med. & Biolol. 2011; 37: 1542–1545, 1550.][Schuhfried O., Vacariu G., Kopf A., Paternosto-Sluga T. Relative slowing of the median antidromic sensory nerve conduction velocity to the ring finger in screening for carpal tunnel syndrome. J. Hand Surg. 2004; 29: 948.][Sunderland S. Nerve and nerve injuries. Edinburgh: Churchill Livingstone, 1978.][Tuncali D., Yuksel Barutcu A., Terzioglu A. et al. Carpal tunnel syndrome: comparison of intraoperative structural changes with clinical and electrodiagnostic severity. Br. J. Plastic Surg. 2005; 58: 1138.][Wernera R.A., Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin. Neurophysiol. 2002; 113: 1373–1375.]