الفهرس 
Role of Conventional Ultrasound and Shear Wave Elastography of Median Nerve in Diagnosis and Differentiation of Carpal Tunnel Syndrome Severity in Correlation with Electrodiagnostic Studies
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Abstract
Objectives and aim of work: To explore the diagnostic performance of several ultrasonography and elastography parameters at diagnosing and grading the severity of carpal tunnel syndrome in correlation with the electrophysiological evaluation of the median nerve.
Background: CTS is an entrapment neuropathy induced by compression of the median nerve as it travels through the carpal tunnel of the wrist. It accounts for 90 percent of all neuropathies and is the most prevalent nerve entrapment neuropathy. The gold standard for CTS diagnosis is abnormalities on electrophysiologic testing in conjunction with specified symptoms. Electrophysiologic testing can also identify the severity of nerve injury.
Methods: The study included 62 wrists. 31 CTS cases with mean age 44.84±10.58. 6 males (19.4%) and 25 females (80.6%) were included. 31 healthy adults served as
control group with mean age 46.71±11.46. 11 males (35.5%) and 20 females (64.5%) were included. All US examinations were done with the subjects were sitting with their upper limbs relaxed on a pillow with forearm in supine position and the fingers are semiflexed. Ultrasound and elastography parameters were recorded. NCS was done by recording median nerve motor and sensory functions and then comparing median nerve versus radial and ulnar nerves if the previous recordings were normal to detect early starting cases.
Results: US and elastography can significantly diagnose CTS and detecting its severity (mild/moderate versus severe CTS).
Conclusion: Ultrasound and Shear wave elastography of the median nerve is a non invasive, highly sensitivive diagnostic modality. It can significantly diagnose CTS and severity of CTS (mild/ moderate cases versus severe cases). The diagnostic accuracy of CTS can be improved by combining high resolution conventional B-mode US and shear wave ultrasound elastography of the median nerve.