Diagnose Carpal Tunnel Syndrome Dodge City KS

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Richard J Ackerman, DDS
(620) 227-2234
705 1st Ave Ste B
Dodge City, KS
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Alok Shah
(620) 227-1371
2020 Central Ave
Dodge City, KS
Specialty
Orthopedic Surgery

Data Provided By:
John Michael Sojka, MD
(317) 917-4347
3901 Rainbow Blvd MS Ste 3017,
Kansas City, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ks Sch Of Med, Kansas City Ks 66103
Graduation Year: 1998

Data Provided By:
Jean-Louis Gabriel
(316) 613-4640
1947 Founders St
Wichita, KS
Specialty
Hand Surgery

Data Provided By:
Milo Goss Sloo
(785) 823-2215
520 S Santa Fe Ave
Salina, KS
Specialty
Orthopedic Surgery

Data Provided By:
Alexander Baxter Neel, MD
(620) 225-7744
2300 N 14th Ave Ste 104
Dodge City, KS
Specialties
Orthopedics, General Surgery
Gender
Male
Education
Medical School: Univ Of Rochester Sch Of Med & Dentistry, Rochester Ny 14642
Graduation Year: 1982
Hospital
Hospital: Pratt Reg Med Ctr, Pratt, Ks; Western Plains Reg Hosp, Dodge City, Ks
Group Practice: Orthopedics & Sports Medicine

Data Provided By:
Kenneth Jansson
(316) 631-1600
2778 N Webb Rd
Wichita, KS
Business
Advanced Orthopaedics Associates
Specialties
Orthopedics, Sports Medicine, Arthroscopic Surgery
Insurance
Insurance Plans Accepted: Almost all insurance plans accepted.
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes

Doctor Information
Primary Hospital: Kansas Surgery and Recovery Center; Surgicare of Wichita
Residency Training: Wilford Hall USAF Medical Center, Lackland AFB, TX
Medical School: Darthmouth, 1982
Additional Information
Member Organizations: American College of Sports Medicine American Medical Association American Medical Society for Sports Medicine American Orthopaedic Society for Sports Medicine Arthroscopy Association of North America Fellow American Academy of Orthopaedic Surgeo


Data Provided By:
James Joseph Jr, MD
(316) 219-8299
9300 E 29th St N Ste 205
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Co Sch Of Med, Denver Co 80262
Graduation Year: 1984

Data Provided By:
Donald Lewis Wilson, DDS
(785) 272-3722
2235 SW Westport Dr
Topeka, KS
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Brad Robert Meister, MD
(620) 421-0881
South Highway 59
Parsons, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1999

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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