Diagnose Carpal Tunnel Syndrome Lake Oswego OR

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James Brendan Mcsherry, DDS
(503) 657-8312
15775 SE 82nd Dr
Lake Oswego, OR
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Michael Raymond Marble, MD
16869 65th Ave PMB 507
Lake Oswego, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Northwestern Univ Med Sch, Chicago Il 60611
Graduation Year: 1967

Data Provided By:
Douglas John Klein, DDS
(503) 636-8491
601 1st St
Lake Oswego, OR
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Jeffrey D Sessions, DMD
(503) 636-5663
15962 Boones Ferry Rd
Lake Oswego, OR
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Rosalyn Marie Montgomery, MD
(503) 699-4042
Lake Oswego, OR
Specialties
Orthopedics
Gender
Female
Education
Medical School: Univ Of Nm Sch Of Med, Albuquerque Nm 87131
Graduation Year: 1986

Data Provided By:
John Walter Swanson, MD
(503) 635-1604
16001 Quarry Rd
Lake Oswego, OR
Specialties
Orthopedics, Legal Medicine
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1970
Hospital
Hospital: Columbia Mem Hosp, Astoria, Or
Group Practice: Columbia Orthopedic Clinic

Data Provided By:
Stephen Fuller, MD
(503) 635-1604
16001 Quarry Rd
Lake Oswego, OR
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
John Walter Swanson
(503) 635-1604
16001 Quarry Rd
Lake Oswego, OR
Specialty
Orthopedic Surgery

Data Provided By:
Dale Van Rhoney, DDS
(503) 635-9371
440 A Ave
Lake Oswego, OR
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Michael Brent Vessely, MD
(503) 358-0983
1455 Chandler Rd
Lake Oswego, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Or Hlth Sci Univ Sch Of Med, Portland Or 97201
Graduation Year: 1986
Hospital
Hospital: Providence St Vincent Med Ctr, Portland, Or
Group Practice: Northwest Permanente Pc

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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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