Abstract

This study aimed to systematically review the evidence on the cross-sectional area of the median nerve in patients with leprosy. High-resolution ultrasonography provides an objective assessment of nerve damage, facilitating early diagnosis and monitoring. Understanding these structural changes can improve disease management and support timely intervention to prevent permanent nerve damage. This systematic review followed PRISMA guidelines, searching five databases up to May 2025 for studies reporting ultrasound-measured cross-sectional area (CSA) of the median nerve in leprosy. Eligible studies were observational or clinical trials in English. Data were extracted and quality assessed using NIH tools, with meta-analysis conducted using RevMan 5.4. The search identified 32 studies, with 8 meeting the inclusion criteria. Quality assessment rated all studies as good. Meta-analysis of 5 studies showed leprosy patients had significantly higher median nerve CSA than controls (MD = 5.48 mm², 95% CI: 2.64–8.33, p-value=0.0002, I² = 93%). Single-arm analysis of 8 studies showed a pooled CSA of 13.28 mm² (95% CI: 11.38–15.17, p

Key words: Leprosy, median nerve, sonography, Hansen's disease, systematic review