Diagnose Carpal Tunnel Syndrome Billings MT

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John R Dorr
(406) 238-6700
2900 12th Ave N
Billings, MT
Specialty
Orthopedic Surgery

Data Provided By:
Perry M Berg, MD
(406) 245-3149
2900 12th Ave N Ste 140W
Billings, MT
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Richard P Lewallen
(406) 237-5050
2900 12th Ave N Ste 140w
Billings, MT
Specialty
Orthopedic Surgery

Data Provided By:
Dr.Jeffrey Hansen
(406) 245-5688
2900 12th Avenue North #315w
Billings, MT
Gender
M
Education
Medical School: Univ Of Wa Sch Of Med
Year of Graduation: 1980
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
1.7, out of 5 based on 3, reviews.

Data Provided By:
Alan Kent Dacre, MD
(406) 238-6540
2900 12th Ave N Ste 140W
Billings, MT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1994
Hospital
Hospital: Riverton Memorial Hospital, Riverton, Wy
Group Practice: Orthopedic Surgeons Yellowstone Medical Center W

Data Provided By:
Steven Jay Klepps, MD
(406) 238-6700
2900 12th Ave N Ste 100E
Billings, MT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Washington Univ Sch Of Med, St Louis Mo 63110
Graduation Year: 1996

Data Provided By:
Guy Robert Schmidt, MD
(406) 238-6540
2900 12th Ave N Ste 140W
Billings, MT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Johns Hopkins Univ Sch Of Med, Baltimore Md 21205
Graduation Year: 1998

Data Provided By:
Gregory S McDowell
(406) 238-6540
2900 12th Ave N
Billings, MT
Specialty
Orthopedic Surgery

Data Provided By:
James F Schwarten
(406) 238-6540
2900 12th Ave N
Billings, MT
Specialty
Orthopedic Surgery

Data Provided By:
Alan K Dacre
(406) 238-6540
2900 12th Ave N
Billings, MT
Specialty
Orthopedic 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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