Diagnose Carpal Tunnel Syndrome Bellaire TX

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Henry Small MD
(713) 864-1506
5420 W Loops S
Bellaire, TX
Specialties
Orthopedics

Data Provided By:
Joseph Fredrick Wade, MD
(931) 388-4276
6565 West Loop S Ste 650
Bellaire, TX
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1989
Hospital
Hospital: Horizon Med Ctr, Dickson, Tn; Maury Regional Hospital, Columbia, Tn
Group Practice: Mid-Tennessee Bone & Joint

Data Provided By:
Bruce Milton Miller, MD
(210) 846-0660
4537 Beech St
Bellaire, TX
Specialties
Orthopedics
Gender
Male
Education
Medical School: Finch U Of Hs/Chicago Med Sch, North Chicago Il 60664
Graduation Year: 1996
Hospital
Hospital: Polly Ryon Hospital Authority, Richmond, Tx
Group Practice: Houston Orthopaedic

Data Provided By:
Richard Randolph maxwell Francis
(713) 383-7100
5420 West Loop S
Bellaire, TX
Specialty
Orthopedic Surgery, Pediatric Surgery, Adult Reconstructive Orthopaedic Surgery, Orthopaedic Surgery of the Spine, Plastic Surgery within the Head & Neck, Trauma Surgery

Data Provided By:
Henry J Blum
(713) 333-9334
5420 West Loop South
Bellairee, TX
Specialty
Orthopedic Surgery

Data Provided By:
Christoph Meyer, MD
(713) 484-6200
8200 Wednesbury Ln
Houston, TX
Business
Center for Spinal Reconstruction
Specialties
Orthopedics

Data Provided By:
David M Wadler, DDS
(713) 667-6000
5001 Bissonnet St Ste 105
Bellaire, TX
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Catherine A Kerr, DDS
(713) 838-9990
6750 West Loop S Ste 410
Bellaire, TX
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Audrey Michelle Boutros, DDS
(713) 218-8338
6750 West Loop S STE 150
Bellaire, TX
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Charles Lawrence Metzger
(713) 333-9334
5420 West Loop S
Bellaire, TX
Specialty
Hand Surgery

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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