Method
Eighteen wheelchair ambulators with spinal cord injury who had neurological level below T2 were studied. Patients with peripheral or central neuropathies were excluded. Patients were assigned to either the electrodiagnostic CTS (group CTS, 7) or electrodiagnostically negative (group non- CTS, 11), and healthy volunteers (15) were classified as control group. The cross sectional area of the median nerve (MN-CSA) at carpal pisiform level was ultrasonographically measured. The degree of painful restriction to execute ADL by hands (TR-ADL), the pain grade (visual analog scale, VAS) of upper extremities and revised version of Korean spinal cord independence measure (KSCIM-R) for functional level were measured and analyzed.

Results
Nine hands (14.3%) of 7 patients out of 34 hands had CTS in electrodiagnostic study. There were significant difference among groups in TR-ADL hours (CTS group; 5.0 vs non-CTS group; 10.2, p＜0.05), VAS (4.1 vs 2.0, respectively, p＜0.05), and no statistical difference in KSCIM-R (68.4 vs 52.1, p＞0.05), MN-CSA (12.3 mm² vs 7.9 mm² vs control group; 8.0 mm², p＜0.05). Using the ROC curve, the cut-off value of MN-CSA produced 8.5 mm² providing a diagnostic sensitivity of 77.8% and specificity of 59.6%.

Conclusion
The ultrasonographic measurement of the median nerve may be a useful non-invasive screening test for the diagnosis of CTS in paraplegic patients with wrist pain. (J Korean Acad Rehab Med 2008; 32: 216-221)