Marwa Yahia, Ahmed El Shambaky, Doaa Lasheen

Department of Rheumatology, Rehabilitation and Physical Medicine, Faculty of Medicine, Benha University, Benha, Egypt

Keywords: Carpal tunnel syndrome, elasticity, electrodiagnosis, elastosonography, functional assessment.


Objectives: This study focused on the symptomatic and the functional evaluation in correlations to median nerve elasticity, its ultrasound parameters, and the electrodiagnostic grading of primary carpal tunnel syndrome (CTS) patients.

Patients and methods: In the case-control study, 100 wrists of 57 CTS patients (54 females, 3 males; mean age: 39±9.8 years; range, 20 to 60 years) clinically diagnosed according to the American Academy of Neurology Clinical Diagnostic Criteria were evaluated between December 2019 and December 2020. The control group included 110 nondiseased wrists of 55 sex- and age-matched healthy subjects (males 7, females 48; mean age: 35.7±10.3 years; range 20 to 58 years). Functional assessment using Hi-Ob-Db clinical scale, electrodiagnosis, ultrasonographic screening, and elasticity evaluation were done for all patients.

Results: CTS patients had an increased stiffness of the median nerve compared to controls. Functional stages were positively correlated with the ultrasonographic parameters and the electrodiagnostic stages of CTS. The elastogram of clinically diagnosed patients was revealed more stiffness of the MN, with negative electrodiagnosis results.

Conclusion: Clinically diagnosed CTS could be missed by the electrodiagnosis but then properly figured by ultrasonography and potentially graded by sonoelastography. Sonoelastography may be an effective method for early diagnosis and appropriate grading of CTS.

Citation: Yahia M, Shambaky AE, Lasheen D. Elastosonography and electrodiagnosis in relation to symptomatic and functional grading of carpal tunnel syndrome. Arch Rheumatol 2023;38(4):620- 632. doi: 10.46497/ArchRheumatol.2023.10022.

Ethics Committee Approval

The study protocol was approved by the Benha University Faculty of Medicine Ethics Committee (date: September 2019, no: MD.5.5 2019). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Creative thinking, writing, practical part, and corresponding author: M.Y.; Supervision and practical guidance: A.E.S.; Supervision and practical guidance: D.L.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.