Diagnose Carpal Tunnel Syndrome Anchorage AK

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William M Dotson, DDS
(907) 563-2828
3401 Denali St Ste 203
Anchorage, AK
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert Wm Lipke, MD
(907) 229-5363
4048 Laurel St Ste 302
Anchorage, AK
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Or Hlth Sci Univ Sch Of Med, Portland Or 97201
Graduation Year: 1972

Data Provided By:
Dr.UPSHUR SPENCER
(907) 563-3145
Suite 220, 3831 Piper Street
Anchorage, AK
Gender
M
Education
Medical School: Georgetown Univ Sch Of Med
Year of Graduation: 1996
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Ronald Irvin Glaeser, DDS
(907) 563-3015
3708 Rhone Cir
Anchorage, AK
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
William J Mills, MD
(907) 562-2277
1544 Hidden Ln
Anchorage, AK
Specialties
Orthopedics
Gender
Male
Education
Medical School: Stanford Univ Sch Of Med, Stanford Ca 94305
Graduation Year: 1950

Data Provided By:
Victoria Matt, MD
(907) 729-1614
Anchorage, AK
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
George Donald Rhyneer, MD
(907) 563-3145
3260 Providence Dr Ste 200
Anchorage, AK
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1993

Data Provided By:
Dr.Tim Kavanaugh
(907) 334-6788
2741 Debarr Rd # C210
Anchorage, AK
Gender
M
Education
Medical School: Finch U Of Hs/Chicago Med Sch
Year of Graduation: 1996
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
3.4, out of 5 based on 4, reviews.

Data Provided By:
Robert Edward Gieringer, MD
(907) 272-7373
2751 Debarr Rd Ste 320
Anchorage, AK
Specialties
Orthopedics
Gender
Male
Education
Medical School: Oh State Univ Coll Of Med, Columbus Oh 43210
Graduation Year: 1973
Hospital
Hospital: Alaska Reg Hosp, Anchorage, Ak; Providence Alaska Med Ctr, Anchorage, Ak

Data Provided By:
Eugene M Chang
(907) 562-2277
3801 Lake Otis Pkwy, Suite 300
Anchorage, AK
Specialty
Orthopedic Surgery, Foot & Ankle Surgery

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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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