A 2025 meta-analysis in HAND concludes that neuromuscular ultrasound (US) and electrodiagnostic (EDX) studies possess statistically equivalent accuracy for confirming carpal tunnel syndrome. While ultrasound showed slightly lower sensitivity (86% vs. 92%) and specificity (79% vs. 82%) than electrodiagnostics, the differences were not significant, justifying ultrasound—typically defined by a median nerve cross-sectional area between 8.8 mm2 and 13.0 mm2—as a primary confirmatory tool. Clinically, ultrasound offers distinct advantages including superior patient tolerability, point-of-care results, and a cost reduction of approximately $400 per study. Furthermore, adopting ultrasound can accelerate surgical timelines by up to four weeks by eliminating the need for outside diagnostic referrals.
