Purpose
Currently, electrodiagnostic testing, which comprises electromyogram (EMG) and nerve
conduction studies (NCS), is the most commonly used method for confirming the clinical
diagnosis of carpal tunnel syndrome (CTS). Electromyogram and NCS can be costly, can
require multiple visits, may induce anxiety, and may be painful for patients. The
purpose of this study was to determine whether replacing EMG/NCS with ultrasound (US),
performed by the treating surgeon, to diagnose CTS decreases time to surgery and the
number of office visits.
Methods
We retrospectively reviewed a database that consisted of patients who presented to
our department with numbness and/or tingling in the hand(s). We assessed the patients’
histories for any subsequent carpal tunnel release, dates of diagnosis, dates of surgery,
the number of CTS-related medical visits, and diagnostic methods employed. A fellowship-trained
hand surgeon performed US examination, and the patients were referred for EMG/NCS
testing. We collected data prior to surgery using the Boston Carpal Tunnel Questionnaire
to evaluate symptom severity scale and functional status scale scores. We performed
linear regression to assess differences in the time to surgery and the number of medical
visits prior to carpal tunnel release.
Results
Patients who had the diagnosis confirmed by the surgeon using US (n = 34) underwent
surgical intervention 3–4 weeks earlier, with 1.8 fewer medical visits on average
than the number of medical visits for those who had their diagnosis confirmed using
EMG/NCS (n = 98).
Conclusions
If a confirmatory method for the diagnosis of CTS is required or desired by the treating
surgeon, surgeon-conducted US might have an impact on the efficiency of care for patients
with CTS.
Type of study/level of evidence
Diagnostic IV.
Key words
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Article info
Publication history
Published online: September 29, 2021
Accepted:
August 2,
2021
Received:
November 14,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
