Ultrasonography for the Diagnosis of Carpal Tunnel Syndrome in Diabetic Patients: Missing the Mark?

Abstract

Purpose: Diabetes mellitus (DM) and carpal tunnel syndrome (CTS) are common pathologies. The diagnosis of CTS can be facilitated by the use of an ultrasound-based wrist-to-forearm ratio (WFR) of the nerve diameter. However, the applicability of WFR in DM-patients is not yet clear. Materials and Methods 233 wrists of 153 patients were examined. Cross-sectional areas (CSA) of the median nerve were obtained using a linear array probe. The WFR was calculated. Results Diabetics with CTS had significantly lower WFR values than non-diabetics with CTS (p=0.002). There was no difference between the WFR of diabetics with and without CTS (p=0.06). The diagnostic accuracy between diabetics with and without CTS was low for measurements of WFR (ROC AUC=0.630, 95% CI 0.541-0.715, p=0.011). Conclusion Our findings suggest that the WFR has a low diagnostic accuracy in diabetic patients with CTS and should be used with caution in those patients. Key Points The diagnostic accuracy of WFR is low in patients with DM WFR should not be used in patients with DM The sonographic evaluation of the median nerve in patients with DMshould focus on morphological changes Citation Format Steinkohl F, Loizides A, Gruber L etal. Ultrasonography for the Diagnosis of Carpal Tunnel Syndrome in Diabetic Patients: Missing the Mark?. Fortschr Röntgenstr 2019; 191: 117-121.