Nível de evidência e grau de recomendação dos artigos sobre a acurácia diagnóstica da ultrassonografia na síndrome do túnel do carpo

Abstract

Objective: The present study was aimed at assessing the quality of articles related to diagnostic accuracy of ultrasonography both in idiopathic and occupational carpal tunnel syndrome. Materials and Methods: A search was undertaken in electronic databases, selecting reports on systematic reviews, randomized clinical trials and observational studies. After four stages of analysis, from an initial screening to the evaluation by means of the assessment scale developed by the Critical Appraisal Skills Programme, the articles were classified according to levels of evidence, with their respective grades of recommendation. Results: Among 68 articles initially identified, only 4 have met all the methodological quality criteria proposed in the present study. Measurement of the cross-sectional area of the median nerve was the most important criterion for the diagnosis of carpal tunnel syndrome (cut-off point between 9 and 10 mm2: sensitivity = 82-86.3%; specificity = 48-87%). The four articles were given level of evidence "1b" and grade of recommendation "A". Conclusion: The sonographic evaluation of patients with clinical suspicion of carpal tunnel syndrome can be cost-effectively performed as a first-line test, reducing the need for electrodiagnostic testing in these patients. © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem.