Background: This study aimed to investigate the morphology of the Median Nerve in Carpal Tunnel Syndrome (CTS) through ultrasound and establish a correlation with findings from the nerve conduction velocity study.

Methods: After receiving ethical clearance and informed consent, 42 patients were enrolled from the Department of Neurology and underwent assessment in the Department of Radiodiagnosis. These patients underwent laboratory examinations to rule out secondary causes of CTS. Each underwent an ultrasound, with examiners blind to the Nerve Conduction Study (NCS) outcomes. Using NCS as the benchmark, we calculated the sensitivity and specificity of the ultrasound, focusing on the cross-sectional area (CSA) of the Median nerve. Statistical analysis using paired t-tests and the Wilcoxon Sign rank test compared the ultrasound and NCS findings.

Results: 42 CTS patients were studied. When benchmarked against NCS, the ultrasound showed concurrence in diagnosing Median Nerve entrapment neuropathy. There was significant variation between the ultrasound diagnosis and NCS parameters, as evidenced by a significance level of 0.000. Furthermore, the unaffected nerve's CSA proximal to the tunnel inlet displayed minimal variance between the two methods.

Conclusion: Variations in ultrasound metrics exist between CTS patients with moderate NCS irregularities and those with normal NCS. This indicates ultrasound's potential as an additional diagnostic tool, especially for early CTS cases without evident nerve conduction anomalies