Median Nerve Ultrasonography Diagnostic Accuracy and Electrodiagnostic Evaluation of Carpal Tunnel Syndrome in Type 2 Diabetes Mellitus

Nicu Cătălin Drăghici^{1, 2, 3}, Daniel-Corneliu Leucuța⁴, Maria Magdalena Tămaș⁵, Tudor Dimitrie Lupescu^{1, 3}, Ștefan Strilciuc^{1, 3}, Simona Rednic⁵, Dafin Fior Mureşanu^{1, 3}

¹Department of Clinical Neurosciences, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania - ²"IMOGEN" Institute, Centre of Advanced Research Studies, Cluj-Napoca, Romania -³"RoNeuro" Institute, Centre for Neurological Research and Diagnostic, Cluj-Napoca, Romania - ⁴Department of Medical Informatics and Biostatistics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania - ⁵Department of Rheumatology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania

Introduction: Carpal tunnel syndrome (CTS) and type 2 diabetes mellitus (DM) are two prevalent pathologies. However, CTS is sometimes challenging to diagnose and can be easily overlooked in diabetic patients. The study aimed to evaluate the diagnostic accuracy of ultrasound (US) to identify CTS in patients with type 2 DM, by using clinical diagnosis and electroneuronography (ENG) testing as a reference standard. 

Material and methods: We conducted a prospective diagnostic accuracy cross-sectional study and we analyzed clinically and performed through US and ENG, 106 wrists of 53 consecutive patients known with type 2 DM.

Results: We have obtained good results regarding the cross-sectional area (CSA) at the wrist, with an area under the receiver operating characteristics (AUROC) = 0.854, 95% CI (0.776 - 0.92) and AUROC = 0.833 95% CI (0.749 - 0.906) for wrist - forearm difference (WFD), respectively. Moreover, the US sensitivity for CTS was 86.1 % at the wrist level for a cut-off at 10.5 mm². Likewise, the WFD had a sensitivity of 83.3 % for a cut-off of 3 mm².

Conclusion: Median nerve US at the wrist had a moderately good diagnostic accuracy in CTS diagnosis in type 2 DM.