Diagnose Carpal Tunnel Syndrome Mableton GA

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F. daniel Koch, M.D.
(770) 491-3003
2680 Lawrenceville Highway
Decatur, GA
Business
Resurgens Orthopedics
Specialties
Orthopedics, General Orthopaedics, Adult Spine Surgery
Insurance
Insurance Plans Accepted: Accept most insurance plans

Doctor Information
Primary Hospital: Dekalb Medical Center
Residency Training: University of Louisville
Medical School: Duke University,
Additional Information
Member Organizations: Fellow, American Academy of Orthopaedic Surgeons
Languages Spoken: English

Data Provided By:
Sami O. Khan, M.D.
(770) 491-3003
2680 Lawrencevill Highway
Decatur, GA
Business
Resrugens Orthopaedics
Specialties
Orthopedics, Arthroscopic and Reconstructive Surgery of the Shoulder, Elbow and Knee, Sports Medicine, General Orthopaedics
Insurance
Insurance Plans Accepted: We accept most insurance plans

Doctor Information
Primary Hospital: Emory Eastside Hospital
Residency Training: New York University Hospital fo rJoint Disease
Medical School: Emory University School of Medicine,
Additional Information
Member Organizations: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, American Orthopaedic Society of Sports Medicine
Awards: Associate Team Physician, New York Mets MLB 2003-2004 Team Physician, Mississippi Valley State Delta Devils 2006-2007 Associate Physician, Alvin Ailey Dance Theater New York, 2004 Author of multiple textbook chapters involving shoulder and elbow injuri
Languages Spoken: English,Spanish

Data Provided By:
Raj Bhole
(770) 944-1100
2041 Mesa Valley Way
Austell, GA
Specialty
Orthopedic Surgery

Data Provided By:
Rafael V Urrutia
(770) 944-1100
2041 Mesa Valley Way
Austell, GA
Specialty
Orthopedic Surgery

Data Provided By:
Todd A Sacks
(770) 944-1100
2041 Mesa Valley Way
Austell, GA
Specialty
Orthopedic Surgery

Data Provided By:
Lawrence A. Bircoll, M.D.
(770) 491-3003
2680 Lawrenceville Highway
Decatur, GA
Business
Resurgens Orthopedics
Specialties
Orthopedics
Insurance
Insurance Plans Accepted: We accept most insurance plans

Doctor Information
Primary Hospital: Dekalb Medical Center
Residency Training: Henry Ford Hospital, Detroit, Michigan
Medical School: University of Michigan School of Medicine,
Additional Information
Member Organizations: American Academy of Orthopaedics Medical Association of Georgia Atlanta Orthoapedic Society
Languages Spoken: English

Data Provided By:
Anthony Cabot, MD
(770) 436-5484
582 Concord Rd Ste C
Smyrna, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Columbia Univ Coll Of Physicians And Surgeons, New York Ny 10032
Graduation Year: 1972

Data Provided By:
Mark S Duffield, DO
(770) 944-7097
1668 Mulkey Rd
Austell, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1983

Data Provided By:
Michael Stuart Slutzky
(678) 842-5402
1668 Mulkey Rd
Austell, GA
Specialty
Hand Surgery

Data Provided By:
Keith Andrew Lamberson, MD
(770) 944-3303
1668 Mulkey Rd
Austell, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Tulane Univ Sch Of Med, New Orleans La 70112
Graduation Year: 1994

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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