Diagnose Carpal Tunnel Syndrome Flowery Branch GA

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John Lee Hemmer Jr, MD
(770) 532-7076
1240 Jesse Jewell Pkwy Ste 300 S Entrance
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 1971
Hospital
Hospital: Northeast Georgia Med Ctr, Gainesville, Ga; Union Gen Hosp, Blairsville, Ga
Group Practice: Gainesville Orthopaedic Assoc

Data Provided By:
Harry Harper Ferran
(770) 532-7092
655 Jesse Jewell Pkwy Se
Gainesville, GA
Specialty
Orthopedic Surgery

Data Provided By:
Bradley Roy Noon, MD
(770) 532-0503
590 S Enota Dr NE
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 1995

Data Provided By:
Amy E Bullens-Borrow, MD
(770) 532-0503
590 S Enota Dr NE
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Derek Ronald Moore, MD
655 Jesse Jewell Pkwy NE Ste B
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Sc Sch Of Med, Columbia Sc 29208
Graduation Year: 1999

Data Provided By:
Robert Marascalco, MD
(770) 534-7200
1240 Jesse Jewell Pkwy SE Ste 300
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ms Sch Of Med, Jackson Ms 39216
Graduation Year: 1972

Data Provided By:
John George Vachtsevanos, MD
(770) 534-7202
1240 Jesse Jewell Pkwy SE Ste 300
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Baylor Coll Of Med, Houston Tx 77030
Graduation Year: 1997

Data Provided By:
James Laydon Cannon, DDS
(770) 532-4156
1225 Sherwood Park Dr NE
Gainesville, GA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Derek Ronald Moore
(770) 532-7092
655 Jesse Jewell Pkwy Se
Gainesville, GA
Specialty
Orthopedic Surgery

Data Provided By:
Michael Bradley Gottsman, MD
(770) 532-7092
655 Jesse Jewell Pkwy SE Ste B
Gainesville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Duke Univ Sch Of Med, Durham Nc 27710
Graduation Year: 1995

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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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