Added Value of Ultrasonography in the Diagnosis, Management, and Follow-up of Carpal Tunnel Syndrome

Background: Carpal tunnel syndrome (CTS) remains one of the most common compression neuropathies affecting the upper extremity. Despite electrophysiological (EP) testing be-ing considered an important diagnostic tool, it has notable lim-itations. Aim of Study: This study aimed to evaluate ultrasonogra-phy (US) and nerve conduction studies (NCS) as complementa-ry tools for CTS diagnosis, treatment planning, and monitoring. Patients and Methods: This retrospective study included 60 patients of both sexes diagnosed with CTS. Patients under-went comprehensive clinical assessment, NCS, and high-reso-lution US before and three months after surgical intervention. Parameters assessed included distal motor latency, cross-sec-tional area, flattening ratio, and anteroposterior dimension of the carpal tunnel. Results: The US demonstrated 90.4% sensitivity and 87.5% specificity for CTS diagnosis, while NCS showed 86.5% sensitivity and 75% specificity. Post-surgical evaluations re-vealed significant improvements in all measured parameters (p<0.001). Additionally, the US identified anatomical varia-tions that influenced management decisions, including aberrant median artery (13.33%) and lipomas (3.33%). Conclusions: The US provides valuable complementary information to EP testing in CTS assessment, offering superior diagnostic accuracy and the ability to detect structural abnor-malities that may influence treatment planning. The combina-tion of clinical examination, electrodiagnostic testing, and US optimizes patient care in CTS management.