All the cases included in the study presented by pain,
65% of cases had paresthesia in addition,
15% showed muscle wasting while 82.5% of the studied cases were diagnosed as carpal tunnel syndrome as shown in table 1.
Table (1): Distribution of the studied cases as regards the presenting symptoms
%
|
No
|
Variables
|
100%
|
40
|
Pain
|
65%
|
26
|
Paresthesia
|
15%
|
6
|
Muscle wasting
|
60%
40%
|
24
16
|
Side
Right
Left
|
82.5%
7.5%
7.5%
2.5%
|
33
3
3
1
|
Site
Carpal tunnel
Cubital
Suprascapular
Guyon’s
|
Regarding the electrophysiological studies results 35% of the studied cases were diagnosed as mild cases while 25% were diagnosed as severe cases as presented in table 2.
Table (2): Distribution of the studied cases as regards the results of electrophysiology
%
|
No
|
Variables
|
10%
|
4
|
Not done
|
35%
|
14
|
Mild
|
27.5%
|
11
|
Moderate
|
2.5%
|
1
|
Moderate to severe
|
25%
|
10
|
Severe
|
Ultrasound was overall positive among 82.5% of the studied cases; while 17.5% of the studied cases were non positive (negative and border line cases) as presented in table 3.
Table (3): Distribution of the studied cases as regard ultrasound results
%
|
No
|
Variables
|
94.6%
|
35
|
Decreased echogenicity
|
17.5%
82.5%
|
7
33
|
Conclusion
Non positive (negative-border line)
Positive
|
Range
|
Mean±SD
|
|
1.8-4.7
|
2.9±0.5
|
Flattening
|
2-6
|
4.2±1.08
|
Bowing
|
6.5-30
|
20.4±5.2
|
Cross sectional area
|
Positive MRI study represents 85% of the studied cases as presented in table 4.
Table (4): Distribution of the studied cases as regards MRI results
%
|
No
|
Variables
|
92.5%
|
37
|
Increased T2 signal
|
92.5%
|
37
|
Increased cross sectional area
|
15%
|
6
|
Muscle signal alteration
|
85%
|
34
|
Conclusion
|
Range
|
Mean±SD
|
|
1.6-4
|
2.8±0.6
|
Flattening
|
0.11-0.30
|
0.19±0.04
|
Bowing
|
Idiopathic etiology was found among 60% of the studied cases as presented in table 5.
Table (5): Distribution of the studied case as regards disease etiology
%
|
No
|
Variables
|
2.5%
|
1
|
Negative
|
60%
|
24
|
Idiopathic
|
37.5%
|
15
|
Extraneural compression
|
There was highly significant difference as regards bowing by using paired t-test.
No significant difference was detected as regards flattening as presented in table 6.
Table (6): Comparison between U/S versus MRI as regards different measures
P
|
t
|
MRI
|
U/S
|
Variables
|
>0.05
NS
|
1.9
|
2.8±0.6
|
2.5±0.93
|
Flattening
|
<0.001
HS
|
3
|
0.19±0.04
|
4.4±1
|
Bowing
|
Highly significant association was identified between U/S versus MRI in the diagnosis of nerve entrapment by using paired Fisher exact test as presented in table 7.
Table (7): Comparison between U/S versus MRI as regards the diagnosis of nerve entrapment
P
|
MRI
Negative Positive
|
U/S
|
<0.001
HS
|
3(7.5%)
|
4(10%)
|
Negative
|
31(77.5%)
|
2(5%)
|
Positive
|
Comparing the ultrasound results to the MRI,
True positive results were present in 77.5% of the studied cases as presented in table 8
Table (8): Validity of U/S compared to MRI results
No
|
Validity
|
31
|
T+ve
|
4
|
T-ve
|
2
|
F+ve
|
3
|
F-ve
|
Ultrasound shows high positive predictive value 89%,
sensitivity 91% and overall accuracy 87.5% but shows low negative predictive value 58% and specificity 67% in diagnosis of nerve entrapment as presented in table 9.
Table (9) Validity variables of U/S versus MRI results among the studied cases
%
|
Validity variables
|
91%
|
Sensitivity
|
67%
|
Specificity
|
89%
|
Positive predictive value
|
58%
|
Negative predictive value
|
87.5%
|
Overall accuracy
|
Representative cases are shown in Fig 1-4