الفهرس 
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Abstract
Carpal tunnel syndrome (CTS) is a common clinical problem and frequently requires surgical therapy. The results of electrodiagnostic (EDX) studies have been found to be highly sensitive and specific for the
diagnosis of CTS (Seror et al., 1998).
CTS diagnosis is based on clinical examination, but electrodiagnosis (EDX) has become a medicolegal obligation before performing surgery (Jablecki et al., 2002).
Sonography is a modern imaging technique, which is making its way into CTS examination. Sonography provides morphologic information on the content (median nerve, flexor tendons, possible cysts, tumors, or muscles, median artery) and the surrounding tissues (bone and anterior ligament) of the carpal tunnel (Hammer et al., 2006).
The aim of our study was to investigate the effectiveness and accuracy of the diagnosis of carpal tunnel syndrome based on ultrasonic scan versus one performed via electromyelography.
The mean age ± SD of the patients with CTS was 35.6±9.5 years and the mean age for healthy controls was 35.1±6.04 years – both groups were comparable referring their age. 78.4% percent of patients were female and 85% of the healthy volunteers were females.
Regarding the electrophysiology studies of our study population, motor latency difference between the two groups was highly significant with p value ˂ 0.0001. CMAP difference was insignificant with p value = 0.768. MCV difference was significant with p = 0.001. Peak latency difference was highly significant with p value ˂ 0.0001. SNAP difference was highly significant with p value ˂ 0.0001.
Regarding ultrasonography, the mean CSA for the CTS patients Was 1.66±0.46 cm2, and for healthy volunteers it was 1.02±0.13 cm2. There was a significant difference in the CSA at the canal outlet between the CTS diseased and healthy control group (p value < 0.0001). Regarding FR, mean in patients was 3.92±1.2 and in healthy volunteers mean was 3.17±0.51, the difference was significant with a p value of < 0.001. Regarding reticular bowing, the mean among cases was 2.75±0.98 and in healthy volunteer it was 1.57±0.78, the difference was significant with a p value of < 0.001. Regarding longitudinal compression sign, the mean among cases was 1.5±0.2 and among controls was 1±0.12, with a highly significant difference (p < 0.001). Bifid median nerve was found in 12.5% of CTS hands and was not found in healthy controls.
Our study showed a CSA sensitivity of 80% and specificity of 95% at a cut-off value of 1.33 cm. Also, our results showed a sensitivity of 75% and specificity of 60% at cut-off value of 3.2.
Conclusion
In conclusion, US is a promising method for the detection of the carpal tunnel syndrome.
Much more work is needed to compare it between different ethnical groups or goups with different BMI, and to improve the methodology of measurement.