Using Ultrasound to Diagnose Carpal Tunnel Syndrome

CTS remains primarily a clinical diagnosis. Ultrasound and EPS are confirmatory studies that complement each other because the former modality provides anatomic information, while the latter assesses function. Use of either depends upon availability and the patient’s specific clinical needs.

Ultrasound may also have a place in evaluating EPS-negative patients with compelling symptoms and signs of CTS. It’s clearly useful for evaluating structural concerns that may be precipitating median neuropathy within the carpal tunnel, as well as determining the cause of continued symptoms following surgery. As our case illustrates, direct visualization of the cause of compressive median neuropathy may prove essential to guide treatment.

As Goethe once said, “One only sees what one looks for.” It may be time to start looking.

Mark H. Greenberg, MD, RMSK, RhMSUS, He did his rheumatology fellowship at the Albert Einstein-Montefiore Medical Center in The Bronx, New York. He is board certified in internal medicine and rheumatology. He is an associate professor of medicine at the University of South Carolina School of Medicine at Palmetto Health USC Medical Group in Columbia, S.C.

Julian Greer received her BS in exercise science from the University of South Carolina. She is a third-year medical student at the University of South Carolina School of Medicine.

James W. Fant Jr., MD, completed his rheumatology fellowship at Wilford Hall USAF Medical Center, Lackland Air Force Base in San Antonio, Texas. He is board certified in internal medicine and rheumatology. He is an associate professor of medicine at the University of South Carolina School of Medicine and director of the Rheumatology Division at Palmetto Health USC Medical Group in Columbia, S.C.

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