Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study

<b>Background/Objectives</b>: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Traditional diagnostics like EMG and NCSs are invasive and do not visualize nerve morphology. This study aims to evaluate the diagnostic and prognostic value of high-resolution ultrasonography i...

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Main Authors: Fabiana Battaglia, Luigi Troisi, Emanuele Cigna, Francesco Stagno d’Alcontres, Vincenzo Rizzo, Gabriele Delia
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/13/1593
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author Fabiana Battaglia
Luigi Troisi
Emanuele Cigna
Francesco Stagno d’Alcontres
Vincenzo Rizzo
Gabriele Delia
author_facet Fabiana Battaglia
Luigi Troisi
Emanuele Cigna
Francesco Stagno d’Alcontres
Vincenzo Rizzo
Gabriele Delia
author_sort Fabiana Battaglia
collection DOAJ
description <b>Background/Objectives</b>: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Traditional diagnostics like EMG and NCSs are invasive and do not visualize nerve morphology. This study aims to evaluate the diagnostic and prognostic value of high-resolution ultrasonography in patients with CTS using a standardized scanning protocol and to evaluate the relationship between sonographic findings and traditional electrodiagnostic results. <b>Methods</b>: In this observational study with both prospective and retrospective components, 31 subjects were included. Between November 2023 and June 2024, 11 symptomatic CTS patients were scheduled for surgical decompression and 14 healthy controls were prospectively enrolled. Additionally, six post-surgical CTS patients who had undergone decompression between 2016 and 2021 were retrospectively included for comparative analysis. All underwent clinical and ultrasonographic assessments of the median nerve at predefined anatomical landmarks. EMG was performed in the CTS groups. Ultrasound was repeated at 1, 3, and 6 months postoperatively to monitor morphological changes. <b>Results</b>: CTS patients had significantly increased the median nerve CSA compared to controls. Postoperative ultrasound showed progressive CSA reduction correlating with clinical improvement and EMG recovery. The CSA correlated moderately to strongly with distal motor latency. <b>Conclusions</b>: High-resolution ultrasound is a reliable, non-invasive tool for diagnosing and monitoring CTS. Standardized protocols are needed to support broader clinical adoption and establish it as a standalone diagnostic method.
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spelling doaj-art-517ef3cf8a954e5087991b7b5503a0f22025-08-20T03:28:28ZengMDPI AGDiagnostics2075-44182025-06-011513159310.3390/diagnostics15131593Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational StudyFabiana Battaglia0Luigi Troisi1Emanuele Cigna2Francesco Stagno d’Alcontres3Vincenzo Rizzo4Gabriele Delia5Department of Plastic and Reconstructive Surgery, University Hospital of Messina “AOU Gaetano Martino”, Via Consolare Valeria 1, 98124 Messina, ItalyIRCCS MultiMedica Group, University Department of Hand Surgery and Rehabilitation, San Giuseppe Hospital, 20123 Milan, ItalyPlastic Surgery and Microsurgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56122 Pisa, ItalyDepartment of Plastic and Reconstructive Surgery, University Hospital of Messina “AOU Gaetano Martino”, Via Consolare Valeria 1, 98124 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98125 Messina, ItalyDepartment of Plastic and Reconstructive Surgery, University Hospital of Messina “AOU Gaetano Martino”, Via Consolare Valeria 1, 98124 Messina, Italy<b>Background/Objectives</b>: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Traditional diagnostics like EMG and NCSs are invasive and do not visualize nerve morphology. This study aims to evaluate the diagnostic and prognostic value of high-resolution ultrasonography in patients with CTS using a standardized scanning protocol and to evaluate the relationship between sonographic findings and traditional electrodiagnostic results. <b>Methods</b>: In this observational study with both prospective and retrospective components, 31 subjects were included. Between November 2023 and June 2024, 11 symptomatic CTS patients were scheduled for surgical decompression and 14 healthy controls were prospectively enrolled. Additionally, six post-surgical CTS patients who had undergone decompression between 2016 and 2021 were retrospectively included for comparative analysis. All underwent clinical and ultrasonographic assessments of the median nerve at predefined anatomical landmarks. EMG was performed in the CTS groups. Ultrasound was repeated at 1, 3, and 6 months postoperatively to monitor morphological changes. <b>Results</b>: CTS patients had significantly increased the median nerve CSA compared to controls. Postoperative ultrasound showed progressive CSA reduction correlating with clinical improvement and EMG recovery. The CSA correlated moderately to strongly with distal motor latency. <b>Conclusions</b>: High-resolution ultrasound is a reliable, non-invasive tool for diagnosing and monitoring CTS. Standardized protocols are needed to support broader clinical adoption and establish it as a standalone diagnostic method.https://www.mdpi.com/2075-4418/15/13/1593carpal tunnel syndromeultrasonographymedian nervecross-sectional areanon-invasive diagnosisnerve decompression
spellingShingle Fabiana Battaglia
Luigi Troisi
Emanuele Cigna
Francesco Stagno d’Alcontres
Vincenzo Rizzo
Gabriele Delia
Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study
Diagnostics
carpal tunnel syndrome
ultrasonography
median nerve
cross-sectional area
non-invasive diagnosis
nerve decompression
title Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study
title_full Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study
title_fullStr Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study
title_full_unstemmed Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study
title_short Standardized High-Resolution Ultrasound Protocol for the Diagnosis and Monitoring of Carpal Tunnel Syndrome: A Mixed-Design Observational Study
title_sort standardized high resolution ultrasound protocol for the diagnosis and monitoring of carpal tunnel syndrome a mixed design observational study
topic carpal tunnel syndrome
ultrasonography
median nerve
cross-sectional area
non-invasive diagnosis
nerve decompression
url https://www.mdpi.com/2075-4418/15/13/1593
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