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Article Open Access

Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study

  • Authors:
    • Jumana Mahdi Kareem
    • Ammar Mosa J. Al‑Mosawe
    • Ibrahim Abdullah Mahmood
    • Ahmed Khairullah Abdulhameed
  • View Affiliations / Copyright

    Affiliations: Department of Physiology, College of Medicine, Al‑Nahrain University, Baghdad, 98HF+2R, Iraq, Department of Surgery, College of Medicine, Al‑Nahrain University, Baghdad, 98HF+2R, Iraq, Iraqi Sport Medicine Center/Ministry of Youth and Sports, Baghdad, 89XH+47F, Iraq
    Copyright: © Kareem et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 11
    |
    Published online on: January 11, 2026
       https://doi.org/10.3892/wasj.2026.426
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Abstract

Carpal tunnel syndrome (CTS) is the most common form of peripheral entrapment neuropathy. Ultrasound (US) has emerged as a valuable diagnostic tool for musculoskeletal conditions, including CTS. The aim of the present study was to evaluate the correlation between the cross‑sectional area of the median nerve (MN) at the distal wrist (CSA‑D) with the severity of CTS, as determined by nerve conduction studies (NCS). For this purpose, a total of 60 female patients with clinical CTS symptoms underwent ultrasound CSA‑D measurements at the carpal tunnel inlet, followed by NCS by a blinded electrophysiologist to the US findings. The results revealed that CSA‑D exhibited a significant positive correlation with MN distal motor latency (R=0.588, P<0.001) and sensory latency (R=0.541, P<0.001). Conversely, a significant negative correlation was observed with motor conduction velocity (R=‑0.373, P=0.003), sensory action potential amplitude (R=‑0.592, P<0.001) and sensory conduction velocity (R=‑0.562, P<0.001). In discriminating mild vs. severe CTS, US had an area under the receiver operating characteristic (ROC) curve (AUC) value of 0.910 (95% CI, 0.826‑0.994, P<0.001), with 95% sensitivity and 86% specificity at CSA‑D=17.5 mm2. On the whole, CSA‑D correlates significantly with NCS parameters in CTS. US is more effective in differentiating mild from severe CTS, than mild from moderate CTS. US is a highly effective modality for distinguishing between mild and severe CTS, demonstrating superior diagnostic performance for this specific differentiation compared to distinguishing mild from moderate disease.

View Figures

Figure 1

Severity of carpal tunnel syndrome in
the patients in the present study.

Figure 2

Association of cross-sectional area of
the median nerve with disease severity as analyzed using the
Kruskal-Wallis test followed by Dunn s post hoc test for
multiple comparisons. ***P<0.001, indicates a highly
statistically significant difference.

Figure 3

Scatter plot and regression line
between median nerve cross-sectional area and distal motor latency
in patients with carpal tunnel syndrome. Median N., median
nerve.

Figure 4

Scatter plot and regression line
between median nerve cross-sectional area and motor velocity in
patients with carpal tunnel syndrome. Median N., median nerve.

Figure 5

Scatter plot and regression line
between median nerve cross-sectional area and sensory action
potential amplitude in patients with carpal tunnel syndrome. Median
N., median nerve.

Figure 6

Scatter plot and regression line
between median nerve cross-sectional area and sensory latency in
patients with carpal tunnel syndrome. Median N., median nerve.

Figure 7

Scatter plot and regression line
between median nerve cross-sectional area and sensory conduction
velocity in patients with carpal tunnel syndrome. Median N., median
nerve.

Figure 8

Receiver operating characteristic
curve for ultrasound in the context of discrimination between mild
and moderate carpal tunnel syndrome. The AUC was 0.763 (95% CI,
0.618-0.908; P=0.009). Ultrasonography exhibited a sensitivity of
67% and a specificity of 62% when the cut-off value of CSA-D was
16.5 mm2.

Figure 9

Receiver operating characteristic
curve for ultrasound in the context of differentiating between mild
and severe carpal tunnel syndrome. The AUC was 0.910 (95% CI,
0.826-0.994; P<0.001). At a cut-off value of CSA-D of 17.5
mm2, ultrasonography exhibited a sensitivity of 95% and
a specificity of 86%.

Figure 10

Receiver operating characteristic
curve for ultrasound in the context of differentiating between
moderate and severe carpal tunnel syndrome. The AUC was 0.774 (95%
CI, 0.607-0.942, P=0.011). At a cut-off value of CSA-D of 20.5
mm2, ultrasonography demonstrated a sensitivity of 63%
and a specificity of 83%.
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Copy and paste a formatted citation
Spandidos Publications style
Kareem JM, Al‑Mosawe AM, Mahmood IA and Abdulhameed AK: <p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>. World Acad Sci J 8: 11, 2026.
APA
Kareem, J.M., Al‑Mosawe, A.M., Mahmood, I.A., & Abdulhameed, A.K. (2026). <p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>. World Academy of Sciences Journal, 8, 11. https://doi.org/10.3892/wasj.2026.426
MLA
Kareem, J. M., Al‑Mosawe, A. M., Mahmood, I. A., Abdulhameed, A. K."<p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>". World Academy of Sciences Journal 8.1 (2026): 11.
Chicago
Kareem, J. M., Al‑Mosawe, A. M., Mahmood, I. A., Abdulhameed, A. K."<p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>". World Academy of Sciences Journal 8, no. 1 (2026): 11. https://doi.org/10.3892/wasj.2026.426
Copy and paste a formatted citation
x
Spandidos Publications style
Kareem JM, Al‑Mosawe AM, Mahmood IA and Abdulhameed AK: <p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>. World Acad Sci J 8: 11, 2026.
APA
Kareem, J.M., Al‑Mosawe, A.M., Mahmood, I.A., & Abdulhameed, A.K. (2026). <p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>. World Academy of Sciences Journal, 8, 11. https://doi.org/10.3892/wasj.2026.426
MLA
Kareem, J. M., Al‑Mosawe, A. M., Mahmood, I. A., Abdulhameed, A. K."<p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>". World Academy of Sciences Journal 8.1 (2026): 11.
Chicago
Kareem, J. M., Al‑Mosawe, A. M., Mahmood, I. A., Abdulhameed, A. K."<p>Median nerve cross sectional area at the distal wrist and nerve conduction findings in patients with carpal tunnel syndrome: A comparative study</p>". World Academy of Sciences Journal 8, no. 1 (2026): 11. https://doi.org/10.3892/wasj.2026.426
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