Diagnose Carpal Tunnel Syndrome Front Royal VA

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Daniel L Zimet
(540) 631-9214
842 N Shenandoah Ave
Front Royal, VA
Specialty
Orthopedic Surgery

Data Provided By:
James Edward Favareau
(540) 636-6177
318 N Royal Ave
Front Royal, VA
Specialty
Orthopedic Surgery

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Amit Kumar Soam, MR
123456789
India
Noida, NY
Specialties
Orthopedics
Gender
Male
Languages
English
Education
Graduation Year: 2000

Data Provided By:
Richard Joseph Patterson, MD
1521 Dalton Pl
Winchester, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1990

Data Provided By:
John H Zoller III, MD
(540) 662-0377
20 S Stewart St # 2698
Winchester, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ohio, Toledo Oh 43699
Graduation Year: 1981

Data Provided By:
James E Favareau, MD
(540) 636-6177
318 N Royal Ave
Front Royal, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1975

Data Provided By:
Daniel Leonard Zimet, MD
(610) 384-4755
842 N Shenandoah Ave
Front Royal, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Pa Sch Of Med, Philadelphia Pa 19104
Graduation Year: 1978

Data Provided By:
Damon W Dearment, DDS
(540) 667-9662
1010 Amherst St
Winchester, VA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
James Thomas Laidlaw, MD
104 Selma Dr
Winchester, VA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ks Sch Of Med, Kansas City Ks 66103
Graduation Year: 1964

Data Provided By:
John Henry Zoller
(540) 667-8975
128 Medical Cir
Winchester, VA
Specialty
Orthopedic Surgery, Orthopaedic Surgery of the Spine

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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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