10 April 2026 : Review article
Carpal Tunnel Syndrome Diagnosis: A Narrative Review of Complementary Roles of Neuromuscular Ultrasound and Electrodiagnostic Studies
Yumeng Dong AEF 1, Yunrui Zhuang AEF 2*, Lingmei Li BDF 2, Yanduo Li BC 2, Huiyan Dai DF 3DOI: 10.12659/MSM.952034
Med Sci Monit 2026; 32:e952034
Table 2 Comparison of sensitivities and specificities for EDX and NMUS parameters.
| Parameter/modality | Study (year) [Ref] | Sensitivity (%) | Specificity (%) | AUC | Severity correlation | Limitations |
|---|---|---|---|---|---|---|
| EDX: TLI (terminal latency index) | Mazaheri et al (2024) []20 | 75.4 | 87.8 | 0.888 | Mild, moderate, severe | Susceptible to various factors (eg, age, hand dominance) affecting diagnostic accuracy |
| EDX: RL (residual latency) | Mazaheri et al (2024) []20 | 85.9 | 82.5 | 0.935 | Mild, moderate, severe | Limited in early CTS; higher sensitivity in moderate and severe cases |
| EDX: FdifMU (median–ulnar F-wave latency difference) | Mazaheri et al (2024) []20 | 87.9 | 82.9 | 0.933 | Severe | Can be influenced by electrode placement and patient condition |
| EDX: MSUMLD (median sensory latency–ulnar motor latency difference) | Mazaheri et al (2024) []20 | 94.8 | 60.0 | 0.883 | Mild, moderate, severe | Sensitivity high for severe CTS, but specificity lower for mild cases |
| NMUS: cross-sectional area (CSA) | Shan et al (2023) []4 | 90.6 | 82.5 | N/A | Severe | False positives possible in early stages; CSA cutoff value influences results |
| NMUS: CSA | Shaukat et al (2024) []50 | 92.8 | 75 | N/A | Early stages | Less effective in detecting early CTS compared to NCS; limitations in severe CTS grading |
| NMUS: CSA (wrist, pisiform-scaphoid) | Shan et al (2023) []4 | 86.5 | 87.3 | N/A | Classic, severe | Poor specificity in mild CTS cases |
| NMUS: CSA | Shauka et al (2024) []50 | 91.6 | 86.8 | N/A | Early CTS | Non-invasive but cannot differentiate severe stages of CTS alone |
| AUC – area under the curve; CSA – cross-sectional area; CTS – carpal tunnel syndrome; EDX – electrodiagnostic studies; FdifMU – median-ulnar F-wave latency difference; MSUMLD – median sensory latency-ulnar motor latency difference; N/A – not available; NCS – nerve conduction studies; NMUS – neuromuscular ultrasound; RL – residual latency; TLI – terminal latency index. | ||||||