护理点超声波结合 CTS-6 诊断特发性腕管综合征。

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science Pub Date : 2025-01-01 DOI:10.1016/j.jos.2024.01.007

Hiroo Kimura , Ryogo Furuhata , Tomoki Matsuo , Taku Suzuki , Noboru Matsumura , Kazuki Sato , Takuji Iwamoto

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引用次数: 0

摘要

背景：本研究旨在证明我们的新诊断图使用点式超声波结合 CTS-6 诊断特发性腕管综合征的有效性：本研究旨在证明我们使用护理点超声波结合CTS-6诊断特发性腕管综合征的新诊断图表的有效性：我们对 2020 年至 2023 年期间到我科就诊并接受护理点超声结合 CTS-6 的患者数据进行了回顾性分析。我们获得了有关年龄、性别、最初和最终诊断、正中神经横截面积、CTS-6评分和电诊断严重程度的数据，并进行了统计分析：在纳入研究的 177 只手腕中，138 只（78%）被诊断为腕管综合征，39 只（22%）未被诊断为腕管综合征（非腕管综合征）。根据我们的诊断方法，127 只手腕（72%）被初步诊断为腕管综合征，23 只手腕（13%）被诊断为非腕管综合征，其余 27 只手腕（15%）被诊断为边缘综合征。除两例病例外，其余病例均被确诊为腕管综合征和非腕管综合征。横截面积、CTS-6 评分和电诊断严重程度呈正相关。事后分析表明，以 31.25 分为临界值的新评分系统（CTS-6 评分 + 2 × 横截面面积）显示出高达 95% 的灵敏度和 100% 的特异性：我们的研究结果表明，大多数疑似特发性腕管综合征病例都能通过诊断图表得到正确诊断。尽管对于边缘病例可能需要额外的工具，包括电诊断研究，但使用护理点超声波结合CTS-6可能是值得推荐的一线确诊检查，因为护理点超声波和CTS-6可作为互补工具，而且该图表可能对非典型或离群病例特别有益：诊断 III 级。

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Point of care ultrasound combined with CTS-6 to diagnose idiopathic carpal tunnel syndrome

Background

This study aimed to demonstrate the effectiveness of our new diagnostic chart using point of care ultrasound combined with CTS-6 for diagnosing idiopathic carpal tunnel syndrome.

Methods

We conducted a retrospective analysis of the data of patients who visited our department and received point of care ultrasound combined with CTS-6 from 2020 to 2023. Data regarding age, sex, initial and final diagnosis, cross-sectional area of the median nerve, CTS-6 score, and electrodiagnostic severity were obtained and statistically analyzed.

Results

Of the 177 wrists included in our study, 138 (78 %) were diagnosed with carpal tunnel syndrome, while 39 (22 %) were not (non-carpal tunnel syndrome). With our diagnostic method, 127 wrists (72 %) were diagnosed initially with carpal tunnel syndrome, 23 wrists (13 %) with non-carpal tunnel syndrome, and the rest 27 wrists (15 %) as borderline. Our initial diagnoses of carpal tunnel syndrome and non-carpal tunnel syndrome were maintained in all cases except for two. Cross-sectional area, CTS-6 score, and electrodiagnostic severity showed a positive correlation. A post hoc analysis showed that the new scoring system (CTS-6 score + 2 × cross-sectional area) with a cutoff value of 31.25 points showed a sensitivity as high as 95 % and a specificity of 100 %.

Conclusions

Our findings suggest that most suspected idiopathic carpal tunnel syndrome cases can be diagnosed correctly using the diagnostic chart. Although additional tools, including electrodiagnostic studies, may be needed for borderline cases, the use of point of care ultrasound combined with CTS-6 may be a recommendable first-line confirmatory test because point of care ultrasound and CTS-6 could be complementary tools, and this chart may be especially beneficial for atypical or outlier cases.

Level of evidence

Diagnostic III.

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来源期刊

Journal of Orthopaedic Science 医学-整形外科

CiteScore

3.00

自引率

0.00%

发文量

290

审稿时长

90 days

期刊介绍： The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.