Diagnose Carpal Tunnel Syndrome Aztec NM

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Dennis Ray Kloberdanz, MD
(505) 327-1400
4700 Samantha Ln
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Co Sch Of Med, Denver Co 80262
Graduation Year: 1983

Data Provided By:
Robert Charles Lehmer, MD
(505) 327-9658
2300 E 30th St Bldg D-101
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1965

Data Provided By:
William Douglas Gurley
(505) 327-1400
2300 E 30th St Bldg D
Farmington, NM
Specialty
Orthopedic Surgery

Data Provided By:
Ernest Lee Stromeyer, DDS
(505) 327-4872
2200 E 20th St
Farmington, NM
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
William Douglas Gurley, MD
(505) 327-1400
2300 E 30th St Bldg D Ste 101
Farmington, NM
Specialties
Orthopedics
Gender
Male
Languages
Spanish
Education
Medical School: U Of Tx Med Sch At Houston, Houston Tx 77225
Graduation Year: 1981
Hospital
Hospital: St Francis Hospital, Tulsa, Ok; Southcrest Hospital, Tulsa, Ok
Group Practice: Springer Clinic Inc

Data Provided By:
Michael Anthony Fallon, MD
(505) 368-6981
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Uniformed Services Univ Of The Hlth Sci, Bethesda Md 20814
Graduation Year: 1994

Data Provided By:
Robert Leonhard Grossheim, MD
(505) 327-9658
2300 E 30th St Bldg D-101
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mo, Columbia Sch Of Med, Columbia Mo 65212
Graduation Year: 1963
Hospital
Hospital: San Juan Reg Med Ctr, Farmington, Nm
Group Practice: Orthopedic Assoc Pa

Data Provided By:
Robert Jerome Bailey, MD
(505) 326-0199
1505 Knudsen Ave
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Nacl Auto De Mexico, Fac De Med, Mexico Df, Mexico
Graduation Year: 1959

Data Provided By:
Jeffrey P Beckenbaugh, DO
2300 E 30th St Bldg D
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Des Moines Univ, Coll Osteo Med & Surg, Des Moines Ia 50312
Graduation Year: 1997

Data Provided By:
Dewey Ivan Getz, DDS
(505) 327-3331
Farmington, NM
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
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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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