Multiparametric Ultrasound Assessment of Carpal Tunnel Syndrome: Beyond Nerve Cross-sectional Area

Semin Musculoskelet Radiol 2024; 28(06): 661-671
DOI: 10.1055/s-0044-1790561

1   Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia

2   Department of Radiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

,

3   Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

,

Domenico Albano

4   IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

5   Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy

,

Suren Armeni Jengojan

6   Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria

,

1   Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia

2   Department of Radiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

› Author Affiliations Source of Funding This research was supported by Slovenian Research Agency (ARiS) grants N3-0256, P3-0043, and J3-4507.
› Further Information Also available at   SFX Search  Buy Article Permissions and Reprints Abstract

Carpal tunnel syndrome (CTS), the most common mononeuropathy, results from compression of the median nerve within the fibro-osseous carpal tunnel. Diagnosis is typically based on clinical evaluation and confirmed by nerve conduction studies. However, ultrasound (US) has emerged as a valuable noninvasive adjunct for CTS confirmation, offering potential advantages over electrodiagnostic testing in terms of patient comfort and diagnostic accuracy. This review begins with a concise summary of carpal tunnel anatomy and CTS pathophysiology as a foundation for exploring the diverse applications of US in CTS evaluation. B-mode US assessment is presented with a focus on cross-sectional imaging and dynamic evaluations, including the transverse translocation and longitudinal gliding of the median nerve. We also review current methods for assessing vascularization in CTS and explore the usefulness of elastography in CTS evaluation. The advantages and limitations of each US method are elucidated, highlighting their practical utility in clinical practice.

Keywords carpal tunnel syndrome - cross-sectional ultrasound - dynamic ultrasound - superb microvascular imaging - elastography

*Shared first authorship.

Publication History

Article published online:
19 November 2024

© 2024. Thieme. All rights reserved.

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