Correlation between the severity of carpal tunnel syndrome and color doppler sonography findings

Carpal tunnel syndrome (CTS) represents one of the most prevalent peripheral
entrapment mononeuropathies. The purpose of our study was to assess the potential correlation
between intraneural hypervascularization, flexor retinaculum bowing, and median nerve
cross-sectional area and the severity of CTS in cases confirmed by nerve conduction study.
SUBJECTS AND METHODS. Sixty consecutive patients with classic or probable
symptoms of CTS were enrolled in the study. A control group consisting of 27 healthy volunteers
who were never diagnosed with CTS or had any symptoms of CTS was recruited among
institution employees. All symptomatic patients were initially examined by a hand surgeon
and subsequently referred for sonographic and electrophysiologic examinations.
RESULTS. A total of 90 wrists (in 60 patients) were included in the study. Twenty-eight
(31.1%) had mild CTS, 33 had moderate disease, and 29 had severe disease. We detected significant
correlation between median nerve hypervascularization and the severity of CTS (p =
0.01, logistic regression) for moderate CTS and (p = 0.04) for severe disease. We also detected
a significant correlation in flexor retinaculum bowing and median nerve cross-sectional area
with increase in the severity of CTS (p < 0.001 and < 0.008; chi-square test and analysis of
variance, respectively).
CONCLUSION. Our study suggests that the severity of CTS strongly correlates with
color Doppler sonography findings, and this technique may represent a reliable complementary
tool in CTS examination