Ultrasonography of Carpal Tunnel Syndrome: Clinical Significance and Limitations in Elderly Patients

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Objective Carpal tunnel syndrome (CTS) severity increases with age. Ultrasonographic measurement of the median nerve cross-sectional area (CSA) is an additional or complementary method for CTS diagnosis. The present study was aimed to investigate the diagnostic significance of median nerve CSA in various age groups of CTS patients. Methods The subjects were patients with electrophysiologically confirmed CTS and age-matched controls. Sonographic measurements of the median nerve CSA were performed. Results A total of 279 hands of 175 patients with CTS and 50 normal hands were examined. CSA was correlated with distal motor and sensory latencies of the median nerve and severity of CTS. CTS severity increased with age, particularly in patients over 80; however, their median nerve CSA was not enlarged regardless of their high severity of CTS. Conclusion Although the median nerve CSA is a useful diagnostic measurement for CTS, it should be emphasized that its diagnostic significance might be limited in aged patients. In particular, in very elderly patients, careful evaluation of CTS severity is necessary.