Considerations about “carpal tunnel syndrome grading using high-resolution ultrasonography”

We have read with attention and appreciation the article “Carpal tunnel syndrome grading using high-resolution ultrasonography,” written by El Habashy et al.,about the use of ultrasound (US) to aid the definition of carpal tunnel syndrome (CTS) severity. The authors assessed the median nerve, by the US, in 42 patients with unilateral or bilateral CTS and in 40 healthy subjects. The diagnosis of CTS was made with neurophysiology and the patients were divided into three groups, on the basis of 3-level grading of neuropathy. The nerve cross sectional area was acquired at carpal tunnel inlet and at forearm. Cross sectional area at wrist and ratio between cross sectional areas at wrist and forearm were compared considering the different groups. The authors found a relevant relation between the nerve dimension (of wrist and wristeforearm ratio) and neurophysiological grading, and they used the wristeforearm ratio to limit the cutoff values of the different disease degree