{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:06:52Z","timestamp":1775819212925,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Evaluate diagnostic accuracy of median nerve cross\u2010sectional area (CSA) to determine severity versus presence of carpal tunnel syndrome (CTS) across existing electrodiagnostic\u2010based (EDX) classification systems in patients with type 2 diabetes or bifid anatomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of cross\u2010sectional patient data. Receiver operating characteristic analysis used to determine median nerve CSA cutoff values and associated diagnostic likelihood ratios for all <jats:italic>consolidated<\/jats:italic> and <jats:italic>binary<\/jats:italic> EDX\u2010based classifications of CTS in patients with type 2 diabetes or bifid anatomy. Determine shifts in diagnostic probability based on established cutoff values and associated likelihood ratios. Distal CSA measured at or near carpal tunnel inlet, proximal CSA at level of pronator quadratus muscle, and delta CSA by subtracting proximal from distal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Binary<\/jats:italic> categorizations of CTS were statistically superior to <jats:italic>consolidated<\/jats:italic> categorizations of CTS severity in patients with type 2 diabetes or bifid anatomy. <jats:italic>Binary<\/jats:italic> categorizations established reasonably consistent median nerve CSA cutoff values across all EDX\u2010based classifications examined resulting in the following for distal CSA or delta CSA: \u226410 or \u22644\u2009mm<jats:sup>2<\/jats:sup> to rule out and \u226511 or \u22655\u2009mm<jats:sup>2<\/jats:sup> to rule in CTS, respectively. These cutoff values resulted in small shifts in diagnostic probability in patients with type 2 diabetes and small to conclusive shifts in diagnostic probability in patients with bifid anatomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Binary<\/jats:italic> categorizations to rule out or rule in CTS based on the proposed cutoff values provide the most meaningful information about shifts in diagnostic probability across all EDX\u2010based classifications examined. The use of median nerve CSA to categorize severity of CTS is not recommended in patients with type 2 diabetes or bifid anatomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16491","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T11:40:24Z","timestamp":1717069224000},"page":"1683-1694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Median Nerve Cross\u2010Sectional Area and Carpal Tunnel Syndrome in Specific Populations"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-7398","authenticated-orcid":false,"given":"Nathan J.","family":"Savage","sequence":"first","affiliation":[{"name":"Department of Physical Therapy Winston\u2010Salem State University  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"McKell","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy McKell Therapy Group, LLC  Provo Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.27053"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.1.FOCUS17802"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2013.03.027"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01362"},{"key":"e_1_2_7_6_1","volume-title":"Electromyography in Clinical Practice: A Case Study Approach","author":"Katirji B","year":"2007"},{"key":"e_1_2_7_7_1","volume-title":"Electromyography and Neuromuscular Disorders: Clinical\u2010Electrophysiologic Correlations","author":"Preston DC","year":"2005"},{"key":"e_1_2_7_8_1","volume-title":"Electrodiagnostic Medicine","author":"Dumitru D","year":"2001"},{"key":"e_1_2_7_9_1","volume-title":"Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice","author":"Kimura J","year":"2001"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195135633.001.0001"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnp.2018.02.005"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20170419-01"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20170627-01"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27124"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v12.i6.101"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnp.2019.04.006"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2018.09.013"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24884"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102808"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm-22-1128"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573405617666210129113548"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000696"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558944718788642"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-019-3010-5"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001104"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2017.07.025"},{"key":"e_1_2_7_27_1","volume-title":"Fundamentals of Musculoskeletal Ultrasound. 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