Objective: To determine forensic implications of carpel tunnel syndrome in relation to neurological, radiological and orthopedic assessments.

Study Design: Prospective

Place and Duration of Study: Department of Forensic Medicine in collaboration with Radiology and Orthopaedic Departments, Govt. Khawaja Muhamamd Safdar Medical College Sialkot from 1st March 2020 to 28th February 2021.

Methodology: One hundred and fifty patients of both genders were enrolled and age between 15-70 years. Details demographics age, sex and body mass index of all patients were recorded after taking written consent. Patients were divided into 2 groups. Group I had 75 patients with carpal tunnel syndrome and group II had 75 patients without carpal tunnel syndrome. Patients were undergone for ultrasonography and ultradiagnostic test used to diagnose the carpal tunnel syndrome. The carpal tunnel and proximal levels of the median nerve's CSA were measured, delta cross-sectional area (CSA) was determined for each wrist based on the differences between CSAc and CSAp. Sensitivity and specificity in wrists among both groups were identified.

Results: There were 15 (20%) males and 60 (80%) females in group I with 90 wrists while in group II 17 (22.7%) males and 58 (77.3%) females in group II with 100 wrists. Mean age in group I was 49.68±9.66 years with mean BMI 26.47±9.54 kg/m2 and in group II mean age was 51.68±9.66 years with mean BMI 25.47±9.54 kg/m2. Mean CSAc in affected wrists group I was 17.11±6.44 greater than group II 08.17±6.58 mm2. Mean delta CSA in healthier wrists was lower 1.01±2.11 than group I 8.44±9.55 mm2. It was shown that the delta-CSA threshold of 2 mm2 had the maximum sensitivity (98.7%) and specificity (100%) in group I than control group.

Conclusion: As compared to CSAc, the CSA is more accurate in diagnosing carpal tunnel syndrome.

Keywords: Carpel tunnel syndrome (CTS), CSA, Wrists, Specificity, Sensitivity, Ultrasonography