ArticleEuropean journal of physical and rehabilitation medicine2024
Successful evaluation of a new image-based parameter for the diagnosis of carpal tunnel syndrome: ultrasound assessment of longitudinal median nerve gliding in patients, healthy volunteers, and cadavers.
Article in European journal of physical and rehabilitation medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Carpal Tunnel Syndrome Diagnosis: A Narrative Review of Complementary Roles of Neuromuscular Ultrasound and Electrodiagnostic Studies.Medical science monitor : international medical journal of experimental and clinical research · 2026Review
- Complementary Role of Ultrasound and Clinical Features in Assessing Carpal Tunnel Syndrome Severity: A Cross-Sectional Study.Diagnostics (Basel, Switzerland) · 2025Article
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7 authors.
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Abstract
backgroundReduced longitudinal median nerve gliding is a new promising diagnostic feature in carpal tunnel syndrome (CTS). However, the complexity of existing ultrasound analysis protocols undermines the application in routine clinical practice.
aimTo provide a simple method for assessing longitudinal gliding with ultrasound, without the need for post-hoc image analysis.
design1) Retrospective cohort study, validation by external blinded reviewers; 2) proof of concept in body donors.
setting1) Outpatient clinic; 2) anatomy department. POPULATION: The population included 48 patients with idiopathic CTS diagnosed by electrodiagnostic testing and ultrasound, as well as 15 healthy controls. Twelve, non-frozen, non-embalmed body donors were enrolled.
methodsLongitudinal gliding of the median nerve in the carpal tunnel was visualized in all patients with idiopathic CTS and healthy controls. All ultrasound videos were pseudonymized, equipped with a scale, and randomized. Videos were analyzed by four independent radiologists, all blinded to clinical characteristics. The endpoint was gliding rated as millimeters. Validity of the technique was tested by using speckle tracking software, and in body donors, directly measuring nerve excursion in situ, simultaneously to ultrasound.
resultsGliding differed significantly between controls and patients with CTS, decreasing with incremental CTS severity. A cut-off value of 3.5 mm to identify patients with CTS, yielded 93.8% sensitivity and 93.3% specificity. Intraclass correlation coefficient among senior author and raters was 0.798 (95% CI 0.513 to 0.900, P<0.001), indicating good reliability. Speckle tracking and especially direct validation in body donors correlated well with ultrasound findings.
conclusionsFirst, longitudinal median nerve gliding can reliably be assessed using this simple technique without the need for complicated procedures. Second, a decrease in gliding was found with progressive severity of CTS. Reproducibility for measured distances is good among raters. CLINICAL REHABILITATION IMPACT: An easy to apply sonography parameter would bolster the diagnostic ability of specialists in physical medicine and rehabilitation in daily routine.
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