Estudo comparativo entre o exame físico, a eletroneuromiografia e a ultrassonografia no diagnóstico da síndrome do túnel do carpo: Influence Statistics

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Estudo comparativo entre o exame físico, a eletroneuromiografia e a ultrassonografia no diagnóstico da síndrome do túnel do carpo

Abstract

. ResumoObjetivoAvaliar a sensibilidade da eletroneuromiografia (ENMG) e da ultrassonografia (USN) no diagnóstico de síndrome do túnel do carpo (STC) comparada com a do exame físico, considerado padrão‐ouro.MétodosEstudo seccional pela análise de prontuários de 56 pacientes com 70 mãos acometidas com STC entre março de 2010 e junho de 2012. A sensibilidade dos exames complementares foi analisada e comparada com a do exame físico.ResultadosConstataram‐se sintomas noturnos em 96,4%, hipotrofia tenar em 62,5% e alteração do tato em 50%. A sensibilidade da USG foi de 67,1% (95% IC, 55,7%‐78,6%); a da associação dos testes do exame físico, de 95,7 (95% IC, 90,0%‐100%); e a da ENMG, de 98,6% (95% IC, 95,7%‐100%). A presença de hipotrofia, de alterações no tato e o maior tempo dos sintomas aumentaram a sensibilidade da USG e do exame físico.ConclusãoA sensibilidade da USG para a STC foi inferior à da ENMG e à do exame físico.AbstractObjectiveTo evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard.MethodsIn this cross‐sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination.ResultsNocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7 to 78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0 to 100%); and electromyography, 98.6% (95% CI: 95.7 to 100%). The presence of atrophy, abnormalities of the sense of touch and longer‐duration symptoms increased the sensitivity of ultrasonography and physical examination.ConclusionThe sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination.