Volume 13 Issue 10
Submission 16 July 2025
Acceptance 28 Aug 2025
Publication 4 October 2025
DIAGNOSTIC ACCURACY OF ELECTRODIAGNOSTIC STUDIES FOR THE EVALUATION OF PATIENTS WITH CARPEL TUNNEL SYNDROME TAKING CLINICAL EXAMINATION AS GOLD STANDARD
1Dr. Saud Ahmed, 2Dr. Shahzeb Ali Bugti, 3Dr. Nusrat, 4Dr. Sharan Ahmed, 5Dr. Mariam Naseer, 6Dr. Matiullah Kakar, 7Dr. Hasina Jan, 8Dr. Shazia Sherani, 9Dr. Zarak Khan, 10Dr. Hatoongul
1Assistant professor Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
2Senior Medical officer Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
3Senior Registrar Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
4Medical Officer Department of Plastic Surgery Liaquat national Hospital Karachi
5PGR Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
6PGR Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
7PGR Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
8Medical Officer Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
9Medical Officer Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
10PGR Department of Plastic Surgery and Burn Unit Bolan Medical Collage Hospital BMCH Quetta
ABSTRACT
Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, presenting with numbness, tingling, and pain in the distribution of the median nerve distel to wrist. Clinical examination is considered the gold standard for diagnosis, while electrodiagnostic studies are frequently used to confirm disease and assess severity, though their accuracy remains debated.
Objective: To determine the diagnostic accuracy of electrodiagnostic studies for the evaluation of patients with CTS, taking clinical examination as the gold standard.
Methods: 138 patients with CTS symptoms, ages 18 to 50, participated in a cross-sectional study at two tertiary care institutions in Karachi and Quetta. Records were kept of the patient’s demographics, symptom profile, and length of illness. A neurological examination, Tinel’s sign, Phalen’s test, and history were used to establish the clinical diagnosis. Every patient had electrodiagnostic testing, including electromyography and nerve conduction investigations. The gold standard for sensitivity, specificity, predictive values, and diagnostic accuracy was clinical diagnosis. Age and gender post-stratification was carried out.
Results: The mean age of the 138 patients was 34.7 ± 9.7 years, with 75 (54.3%) being female and 63 (45.7%) being male. Pain (34.8%) and numbness (34.8%) were the most prevalent symptoms. According to electrodiagnostic investigations, the overall diagnostic accuracy was 53.6%, with sensitivity of 54.7%, specificity of 52.7%, PPV of 50.0%, and NPV of 57.4%. Compared to younger patients and females, stratified analysis showed that patients between the ages of 36 and 50 had superior diagnostic ability (accuracy 62.5%) and were more likely to be male (accuracy 60.3%).
Conclusion: When compared to clinical examination, electrodiagnostic tests demonstrated poor sensitivity and specificity and limited diagnostic accuracy. Although they performed better in male patients and older patients, their total performance was still below par. These results lend credence to the idea that electrodiagnostic testing should be used in conjunction with clinical evaluation, not in place of it, when diagnosing CTS.
Keywords: Carpal Tunnel Syndrome, Electrodiagnostic Studies, Nerve Conduction Studies, Electromyography, Diagnostic Accuracy
