Background: There is no universally accepted gold standard
for decision-making regarding the choice of surgery for
carpal tunnel syndrome. A combination of clinical examination
and electrophysiological studies has been commonly used for
the diagnosis of CTS and grading its severity with the recent
introduction of ultrasonographic examination as a reliable
diagnostic tool. In severe cases of CTS, carpal tunnel release
surgery is usually done, while patients with mild or moderate
degree of the disease usually start with conservative treatment.
Knowing which diagnostic test more accurately reflects the
severity of CTS is mandatory for proper decision-making
regarding management.
Objective: To correlate preoperative diagnostic tools
(clinical presentation, Nerve conduction study, and US)
findings with intraoperative findings to find out which one
of these preoperative diagnostic tools plays the greatest role
in the decision-making process regarding the choice of surgery.
Method: Surgically treated 18 patients diagnosed with
carpal tunnel syndrome (CTS) were included in the study. A
correlation between clinical, electrophysiological, and ultrasonographic
data and intraoperative findings was done.
Results: Statistical analysis shows positive correlation
between clinical, electrophysiological and ultrasonographic
data, and intraoperative findings with electrophysiological
studies being the best and only statistically significant predictor
of severity.
Conclusion: Electrophysiological studies provide the best
predictor of the severity of CTS but more studies are needed
to test the accuracy of these results.