Ultrasonography as a diagnostic tool for clinically manifested carpal tunnel syndrome with normal nerve conduction study. Letter to Editor. Response to Salah et al. | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 24 June 2025 | ||||
| Document Type: Letter to the Editor | ||||
| DOI: 10.21608/ijma.2025.371859.2162 | ||||
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| Authors | ||||
DIANA LY-LIU 1; JOSE-LUIS ANDREU 2; DOMINGO LY  3
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| 1Department of Anesthesia, Basurto University Hospital, Bilbao, Bizkaia, Spain | ||||
| 2Rheumatology Department. Hospital Universitario Puerta de Hierro Majadahonda. Majadahonda (Madrid). Spain. School of Medicine. Universidad Autónoma de Madrid. | ||||
| 3COOTEHILL MEDICAL CENTRE | ||||
| Abstract | ||||
| We read with great interest the recent article by Salah et al., “Ultrasonography as a diagnostic tool for clinically manifested carpal tunnel syndrome with normal nerve conduction study”. [1] Nerve conduction studies (NCS) have traditionally been considered the gold standard for diagnosing carpal tunnel syndrome (CTS). However, the correlation between NCS findings and CTS symptomatology is often poor. Clinical symptoms can precede electrophysiological changes by months or even years. In recent decades, ultrasonography (US) has gained increasing popularity as a diagnostic tool, as it is more affordable, less time-consuming, and more comfortable for patients. Moreover, numerous studies have demonstrated that US has comparable sensitivity and even greater specificity than NCS. Several previous studies have also shown the value of US in diagnosing CTS, even in cases with normal NCS results,[2] suggesting that US and NCS may be complementary rather than mutually exclusive. [3] Many clinicians who manage CTS consider that while NCS primarily assesses median nerve function, US offers a structural view of nerve compression within the carpal tunnel. In some cases, US can even reveal the underlying cause of the compression, aiding in treatment planning. [3] It has also been argued that NCS are not strictly necessary for initiating appropriate and timely treatment (including surgical intervention) but are often used to provide documentation in case of future medicolegal issues. Therefore, CTS diagnosis should be based primarily on clinical signs and symptoms, supported by abnormal NCS findings when available, but not dependent on them. [4] Setting aside the ongoing debate about the superiority of US, NCS, or their combined use in diagnosing CTS, we would like to emphasize the fundamental role of clinical evaluation. CTS is, above all, a clinical diagnosis. Early treatment of CTS symptoms is crucial to reduce patient suffering, improve sleep, and enhance quality of life | ||||
| Keywords | ||||
| ULTRASONOGRAPHY; CARPAL TUNNEL SYNDROME; NERVE CONDUCTION STUDIES | ||||
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