Accuracy of Ultrasonography Diagnostic Tests in Carpal Tunnel Syndrome (Electromyography-Nerve Conduction Velocity as Gold Standard)

Introduction: Carpal Tunnel Syndrome is a collection of symptoms (pain in the median nerve distribution, numbness, tingling to motor weakness or muscle atrophy) due to ischemic compression of the median nerve. This causes a decrease in quality of life and disrupts work. EMG-NCV is a gold standard diagnostic tool with high sensitivity and specificity, but it is uncomfortable, high costs and an inadequate number of devices. Methods: The authors consider the use of ultrasound with a specificity of 86.8% and a sensitivity of 77.6%, providing more convenience, lower cost, a greater number of devices available. Moreover, some literature explains that ultrasound can diagnose CTS earlier. Thus, the author conducted diagnostic test research with a cross-sectional design. The research sample underwent ultrasound and EMG-NCV examination, then receiver operating characteristic analysis was carried out to obtain cut-off point and analyze sensitivity, specificity and accuracy. Results: The results of this study showed that mid-carpal CSA on ultrasound with a cut point of 12.5 mm2 could be used to predict the diagnosis of CTS with a sensitivity of 78% and a specificity of 52.4% with a predictive power of 74.7%. In addition, each clinical grade is related to the ultrasound grade and EMG-NCV. Hence, ultrasound can confirm the diagnosis of CTS and can be applied in all healthcare facilities that have ultrasound so that the distribution of diagnosis of patients with CTS can be more even and make health services easier and faster. Conclusion: It can be concluded that the ultrasound test (Mid-Carpal CSA) is sensitive, non-specific and accurate in diagnosing carpal tunnel syndrome. And, from this research, ultrasound can determine the severity of carpal tunnel syndrome. However, researchers recommend that this research be continued with a larger sample size to be more representative in determining the severity of carpal tunnel syndrome from an ultrasound examination. Keywords: CTS, USG, CSA, EMG-NCV, diagnostic