ULTRASONOGRAPHY AND NERVE CONDUCTION STUDIES COMPARED WITH INTRAOPERATIVE FINDINGS IN CARPAL TUNNEL SYNDROME: A DIAGNOSTIC ACCURACY STUDY

Abstract

Background: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy and decision‑making becomes difficult when symptoms are prolonged, bilateral, or discordant with bedside tests. Objectives: To compare the diagnostic performance of ultrasonography (USG) and nerve conduction studies (NCS) against intraoperative findings. Methods: In a hospital‑based diagnostic evaluation, 46 clinically suspected CTS patients underwent high‑resolution ultrasonography (USG) and nerve conduction studies (NCS). A total of 60 wrists were analyzed (including 14 bilateral cases). Intraoperative findings at carpal tunnel release were treated as the reference standard. Results: CTS was confirmed intraoperatively in 52/60 wrists (86.7%). USG showed sensitivity of 92.3% and specificity of 87.5% (accuracy 91.7%). NCS showed sensitivity of 94.2% and specificity of 75% (accuracy 91.7%). USG flattening ratio alone was specific (90.9%) but less sensitive (63.3%). Conclusion: Both USG and NCS performed well when compared with intraoperative confirmation. USG offered higher specificity in this cohort, while NCS retained slightly higher sensitivity. A combined, context‑driven approach may reduce missed or over‑called CTS when surgery is being considered.