Diagnose Carpal Tunnel Syndrome Espanola NM

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Arnold Barry Wise, MD
(505) 747-4144
1010 Spruce St
Espanola, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1970

Data Provided By:
Marion L Messersmith, DDS
(505) 662-4934
3250 Trinity Dr Ste A
Los Alamos, NM
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Charles Roy Pribyl, MD
(505) 262-3969
14004 Mundo Ct NE
Albuquerque, NM
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Tulane Univ Sch Of Med, New Orleans La 70112
Graduation Year: 1980

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:
Michael T Thieken
(260) 602-5337
201 Cedar St Se
Albuquerque, NM
Specialty
Orthopedic Surgery

Data Provided By:
Matthew W McKinley
(505) 753-7111
1010 Spruce St
Espanola, NM
Specialty
Orthopedic Surgery

Data Provided By:
Anthony F Pachelli, MD
(505) 724-4300
201 Cedar St SE
Albuquerque, NM
Business
New Mexico Orthopaedic Associates
Specialties
Orthopedics

Data Provided By:
Michael E Mc Cutcheon, MD
(505) 242-5205
201 Cedar St SE Ste 6600
Albuquerque, NM
Specialties
Orthopedics
Gender
Male
Languages
Spanish
Education
Medical School: Univ Of Md Sch Of Med, Baltimore Md 21201
Graduation Year: 1969
Hospital
Hospital: Albuquerque Reg Med Ctr, Albuquerque, Nm; Presbyterian Hospital, Albuquerque, Nm
Group Practice: New Mexico Orthopaedic Assoc New Mexico Spine

Data Provided By:
Omar Nizar Osmani, MD
(505) 622-7600
115 E 19th St
Roswell, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: American Univ Of Beirut, Fac Of Med, Beirut, Lebanon
Graduation Year: 1993

Data Provided By:
Michael James Archibeck, MD
(505) 724-4347
201 Cedar St SE Ste 6600
Albuquerque, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ca, Los Angeles, Ucla Sch Of Med, Los Angeles Ca 90024
Graduation Year: 1993

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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