Diagnose Carpal Tunnel Syndrome Johnstown PA

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Brian E Gunnlaugson
(814) 535-6521
321 Main St
Johnstown, PA
Specialty
Orthopedic Surgery

Data Provided By:
Brian Earl Gunnlaugson, MD
(814) 539-7417
321 Main St Ste 3C
Johnstown, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mem Univ Of Newfoundland, Fac Of Med, St Johns, Nfld, Canada
Graduation Year: 1984
Hospital
Hospital: Upmc Lee Hosp, Johnstown, Pa; Conemaugh Mem Med Ctr, Johnstown, Pa
Group Practice: Upmc Lee Regional Care Ctrs

Data Provided By:
Scott Q Little, DDS
(814) 262-0123
344 Budfield St Ste 1
Johnstown, PA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Edward B Hill
(814) 535-1600
1111 Franklin St
Johnstown, PA
Specialty
Orthopedic Surgery

Data Provided By:
Peter James Ridella, MD
(814) 535-5554
1111 Franklin St Ste 140
Johnstown, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Pittsburgh Sch Of Med, Pittsburgh Pa 15261
Graduation Year: 1975
Hospital
Hospital: Upmc Lee Hosp, Johnstown, Pa; Conemaugh Mem Med Ctr, Johnstown, Pa; Windber Hospital & Wheeling Cl, Windber, Pa
Group Practice: Valley Orthopedics Inc

Data Provided By:
William Chua Go Jr, MD
(814) 467-6653
609 Somerset St
Johnstown, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Santo Tomas, Fac Of Med And Surg, Manila, Philippines
Graduation Year: 1968

Data Provided By:
Martin M Dudas, DMD
(814) 535-8321
538 Vine St
Johnstown, PA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Edward Brown Hill, MD
(814) 535-1600
1111 Franklin St Ste 110
Johnstown, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1960
Hospital
Hospital: Upmc Lee Hosp, Johnstown, Pa; Conemaugh Mem Med Ctr, Johnstown, Pa
Group Practice: Highland Orthopedics

Data Provided By:
Trevor Wayne Yardley
(814) 269-3251
411 Theatre Drive
Johnstown, PA
Specialty
Orthopedic Surgery

Data Provided By:
Vincent E Vena
(814) 255-6781
2 Celeste Dr
Johnstown, PA
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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