Magnetic resonance imaging compared with electrodiagnostic studies in patients with suspected carpal tunnel syndrome: Predicting symptoms, function, and surgical benefit at 1 year

Jeffrey G. Jarvik, Bryan A. Comstock, Patrick J. Heagerty, David R. Haynor, Deborah Fulton-Kehoe, Michel Kliot, Gary M. Franklin

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Object. The goal in this study of patients with clinical carpal tunnel syndrome (CTS) was to compare the usefulness of magnetic resonance (MR) imaging with that of electrodiagnostic studies (EDSs) for the following purposes: 1) prediction of 1-year outcomes and 2) identification of patients who are likely to benefit from surgical treatment. Methods. The authors prospectively enrolled 120 patients with clinically suspected CTS. The participants were tested using standardized EDSs, MR imaging, and a battery of questionnaires, including the Carpal Tunnel Syndrome Assessment Questionnaire, a well-validated 5-point score of symptoms and function. The EDSs and MR images were each interpreted independently. Patients were reevaluated after 1 year. The decision to treat patients conservatively or by carpal tunnel release was made by the individual surgeon, who had access to the initial EDS but not MR imaging results. Univariate and multivariate analyses were used to determine associations between 1-year outcomes and baseline diagnostic tests. Results. The authors recontacted 105 of 120 participants at 12 months. Of these, 30 patients had had surgery and 75 had not. Patients who had undergone surgery showed greater improvement at 1 year than those who had not had surgery. The length of the abnormal T2-weighted nerve signal on MR imaging and median-ulnar sensory latency difference were the strongest predictors of surgical benefit. There was a clear patient preference for the MR imaging over EDSs. Conclusions. The findings obtained with MR imaging of the carpal tunnel predict surgical benefit independently of nerve conduction studies.

Original languageEnglish (US)
Pages (from-to)541-550
Number of pages10
JournalJournal of neurosurgery
Volume108
Issue number3
DOIs
StatePublished - Mar 2008

Keywords

  • Carpal tunnel syndrome
  • Magnetic resonance imaging
  • Outcome
  • Peripheral nerve

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Magnetic resonance imaging compared with electrodiagnostic studies in patients with suspected carpal tunnel syndrome: Predicting symptoms, function, and surgical benefit at 1 year'. Together they form a unique fingerprint.

Cite this