The diagnostic accuracy of high-resolution ultrasound in screening for carpal tunnel syndrome and grading its severity is moderated by age

Christos Moschovos, Georgios Tsivgoulis, Andreas Kyrozis, Apostolia Ghika, Persefoni Karachalia, Konstantinos Voumvourakis, Elisabeth Chroni

Research output: Contribution to journalArticle

Abstract

Objective: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). Methods: Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR). Healthy controls underwent identical testing (N = 122 wrists). HRUS accuracy was assessed against the EDx standard by Receiver Operator Characteristic (ROC) curve analysis. Results: In patients >65 y with moderate and severe CTS, disease-related increases in CSA and WFR were negatively correlated with increasing age. Subjects were grouped by age into younger (<65 y) and older (≥65 y). The c-statistics for CSA and WFR respectively were: For CTS diagnosis, younger group: 0.94 and 0.96 (excellent); older group: 0.85 and 0.86 (satisfactory). For CTS grading, younger group: differentiating mild CTS from controls: 0.90 and 0.92 (excellent); mild from moderate: 0.79 and 0.74 (satisfactory); moderate from severe: 0.82 and 0.78 (satisfactory). For CTS grading, older group: differentiating mild CTS from controls: 0.83 and 0.83 (satisfactory); mild from moderate: 0.53 and 0.61 (poor); moderate from severe: 0.65 and 0.53 (poor). Conclusions: For subjects aged <65 y, HRUS accuracy is excellent in CTS diagnosis and satisfactory in grading. For older subjects, accuracy is satisfactory in diagnosis but not in grading. Significance: HRUS for CTS has diagnostic limitations selectively in older individuals.

Original languageEnglish (US)
Pages (from-to)321-330
Number of pages10
JournalClinical Neurophysiology
Volume130
Issue number3
DOIs
StatePublished - Mar 1 2019

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Carpal Tunnel Syndrome
Wrist
Median Nerve
Forearm
Signs and Symptoms

All Science Journal Classification (ASJC) codes

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

The diagnostic accuracy of high-resolution ultrasound in screening for carpal tunnel syndrome and grading its severity is moderated by age. / Moschovos, Christos; Tsivgoulis, Georgios; Kyrozis, Andreas; Ghika, Apostolia; Karachalia, Persefoni; Voumvourakis, Konstantinos; Chroni, Elisabeth.

In: Clinical Neurophysiology, Vol. 130, No. 3, 01.03.2019, p. 321-330.

Research output: Contribution to journalArticle

Moschovos, Christos ; Tsivgoulis, Georgios ; Kyrozis, Andreas ; Ghika, Apostolia ; Karachalia, Persefoni ; Voumvourakis, Konstantinos ; Chroni, Elisabeth. / The diagnostic accuracy of high-resolution ultrasound in screening for carpal tunnel syndrome and grading its severity is moderated by age. In: Clinical Neurophysiology. 2019 ; Vol. 130, No. 3. pp. 321-330.
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abstract = "Objective: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). Methods: Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR). Healthy controls underwent identical testing (N = 122 wrists). HRUS accuracy was assessed against the EDx standard by Receiver Operator Characteristic (ROC) curve analysis. Results: In patients >65 y with moderate and severe CTS, disease-related increases in CSA and WFR were negatively correlated with increasing age. Subjects were grouped by age into younger (<65 y) and older (≥65 y). The c-statistics for CSA and WFR respectively were: For CTS diagnosis, younger group: 0.94 and 0.96 (excellent); older group: 0.85 and 0.86 (satisfactory). For CTS grading, younger group: differentiating mild CTS from controls: 0.90 and 0.92 (excellent); mild from moderate: 0.79 and 0.74 (satisfactory); moderate from severe: 0.82 and 0.78 (satisfactory). For CTS grading, older group: differentiating mild CTS from controls: 0.83 and 0.83 (satisfactory); mild from moderate: 0.53 and 0.61 (poor); moderate from severe: 0.65 and 0.53 (poor). Conclusions: For subjects aged <65 y, HRUS accuracy is excellent in CTS diagnosis and satisfactory in grading. For older subjects, accuracy is satisfactory in diagnosis but not in grading. Significance: HRUS for CTS has diagnostic limitations selectively in older individuals.",
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T1 - The diagnostic accuracy of high-resolution ultrasound in screening for carpal tunnel syndrome and grading its severity is moderated by age

AU - Moschovos, Christos

AU - Tsivgoulis, Georgios

AU - Kyrozis, Andreas

AU - Ghika, Apostolia

AU - Karachalia, Persefoni

AU - Voumvourakis, Konstantinos

AU - Chroni, Elisabeth

PY - 2019/3/1

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N2 - Objective: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). Methods: Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR). Healthy controls underwent identical testing (N = 122 wrists). HRUS accuracy was assessed against the EDx standard by Receiver Operator Characteristic (ROC) curve analysis. Results: In patients >65 y with moderate and severe CTS, disease-related increases in CSA and WFR were negatively correlated with increasing age. Subjects were grouped by age into younger (<65 y) and older (≥65 y). The c-statistics for CSA and WFR respectively were: For CTS diagnosis, younger group: 0.94 and 0.96 (excellent); older group: 0.85 and 0.86 (satisfactory). For CTS grading, younger group: differentiating mild CTS from controls: 0.90 and 0.92 (excellent); mild from moderate: 0.79 and 0.74 (satisfactory); moderate from severe: 0.82 and 0.78 (satisfactory). For CTS grading, older group: differentiating mild CTS from controls: 0.83 and 0.83 (satisfactory); mild from moderate: 0.53 and 0.61 (poor); moderate from severe: 0.65 and 0.53 (poor). Conclusions: For subjects aged <65 y, HRUS accuracy is excellent in CTS diagnosis and satisfactory in grading. For older subjects, accuracy is satisfactory in diagnosis but not in grading. Significance: HRUS for CTS has diagnostic limitations selectively in older individuals.

AB - Objective: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). Methods: Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR). Healthy controls underwent identical testing (N = 122 wrists). HRUS accuracy was assessed against the EDx standard by Receiver Operator Characteristic (ROC) curve analysis. Results: In patients >65 y with moderate and severe CTS, disease-related increases in CSA and WFR were negatively correlated with increasing age. Subjects were grouped by age into younger (<65 y) and older (≥65 y). The c-statistics for CSA and WFR respectively were: For CTS diagnosis, younger group: 0.94 and 0.96 (excellent); older group: 0.85 and 0.86 (satisfactory). For CTS grading, younger group: differentiating mild CTS from controls: 0.90 and 0.92 (excellent); mild from moderate: 0.79 and 0.74 (satisfactory); moderate from severe: 0.82 and 0.78 (satisfactory). For CTS grading, older group: differentiating mild CTS from controls: 0.83 and 0.83 (satisfactory); mild from moderate: 0.53 and 0.61 (poor); moderate from severe: 0.65 and 0.53 (poor). Conclusions: For subjects aged <65 y, HRUS accuracy is excellent in CTS diagnosis and satisfactory in grading. For older subjects, accuracy is satisfactory in diagnosis but not in grading. Significance: HRUS for CTS has diagnostic limitations selectively in older individuals.

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