Diagnose Carpal Tunnel Syndrome Aiea HI

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Byron Hideo Izuka
(808) 485-8985
98-1079 Moanalua Rd
Aiea, HI
Specialty
Orthopedic Surgery

Data Provided By:
Masao Takai, MD
(808) 488-1665
99-128 Aiea Heights Dr Ste 705
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kyoto Prefectural Med Coll, Kamikyo-Ku, Kyoto, Japan
Graduation Year: 1966

Data Provided By:
Randal D Morita, DDS
(808) 486-5505
98-1247 Kaahumanu St Ste 325
Aiea, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Gregory Henkuo Chow, MD
98-1079 Moanalua Rd
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Duke Univ Sch Of Med, Durham Nc 27710
Graduation Year: 1988

Data Provided By:
Curtis N Kamisugi, DDS
(808) 483-3000
99-128 Aiea Heights Dr Ste 201
Aiea, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Byron Hideo Izuka, MD
(808) 485-8985
98-1079 Moanalua Rd Ste 600
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hi John A Burns Sch Of Med, Honolulu Hi 96822
Graduation Year: 1994

Data Provided By:
Stacey Dale Mc Clure, MD
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Az Coll Of Med, Tucson Az 85724
Graduation Year: 1999

Data Provided By:
Terry Alan Vernoy, MD
(808) 533-3393
98-1079 Moanalua Rd
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduation Year: 1978

Data Provided By:
Alan S T Chang, DDS
(808) 487-2411
98-1247 Kaahumanu St Ste 202
Aiea, HI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Cass Keiji Nakasone, MD
98-151 Pali Momi St
Aiea, HI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hi John A Burns Sch Of Med, Honolulu Hi 96822
Graduation Year: 1998

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Best Way to Diagnose Carpal Tunnel Syndrome

Dr. Brent Graham at the Toronto Western Hospital (Canada) has been working on finding the best way to diagnose carpal tunnel syndrome (CTS). Currently, there isn't a clear consensus on the best clinical tests to use in making this diagnosis.

Carpal tunnel syndrome is a common problem affecting the hand and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist. Carpal tunnel syndrome is also known as nerve entrapment or compressive neuropathy. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of carpal tunnel syndrome.

In the past, Dr. Graham tested and validated a new clinical tool called the CTS-6. This instrument is a diagnostic scale for carpal tunnel syndrome. It includes six tests from the history and physical exam to estimate the likelihood that carpal tunnel syndrome is present. The CTS-6 has been tested and validated as a reliable instrument.

Now, in this study, Dr. Graham compared the results of the CTS-6 with electrodiagnostic testing. Electrodiagnostic testing consisted of sensory nerve conduction velocity (NCV). A segment of the median nerve was tested from the wrist to the middle finger.

There were several steps in this study. First, a hand therapist tested all new patients referred to the center for possible upper extremity peripheral nerve problem. The CTS-6 test was used to determine the pre-test chances the patient had carpal tunnel syndrome. Then these same patients were tested using a standard nerve conduction velocity test.

With the CTS-6 scale, each of the six items is given a point value. The six items include 1) numbness in the hand and fingers supplied by the median nerve, 2) muscle atrophy and/or weakness, 3) a positive Phalen test (standard clinical test used to diagnose carpal tunnel syndrome), 4) loss of two-point discrimination (feeling two separate points touched on the skin), 5) numbness at night that wakes the patient up, and 6) a positive Tinel sign (another standard clinical test used to diagnose carpal tunnel syndrome).

A total score of 12 or more suggests a strong probability (80 per cent chance) that the patient has carpal tunnel syndrome. A total score less than five indicates a very small chance (25 per cent) that the patient has carpal tunnel syndrome.

Comparing the results of the CTS-6 test with the results of the nerve conduction velocity test, the authors report the added information from the electrodiagnostic test was not enough to change the diagnosis or warrant the expense. A low probability of carpal tunnel syndrome (judged by the CTS-6) in a patient whose nerve conduction velocity was negative only lowered the chances of the diagnosis being carpal tunnel syndrome. There wasn't much value added by the electrodiagnostic test -- not enough to support the cost and discomfort to the patient.

With the availability of the CTS-6, there is much less...

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