Diagnose Carpal Tunnel Syndrome Maryland Heights MO

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Robert A Shively, MD
(314) 652-4100
915 N Grand Ave
Saint Louis, MO
Business
Washington University Orthopedics
Specialties
Orthopedics

Data Provided By:
Osmond G Jones, DDS
(314) 344-1121
2388 Schuetz Rd
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Terry Joe Weis, DO
(314) 837-5555
12277 de Paul Dr Ste 100
Bridgeton, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hlth Sci, Coll Of Osteo Med, Kansas City Mo 64124
Graduation Year: 1973

Data Provided By:
Dennis J Brady, DDS
(314) 739-3163
12139 Natural Bridge Rd
Bridgeton, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Dr.William Schroer
(314) 291-3399
12266 De Paul Dr # 220
Bridgeton, MO
Gender
M
Education
Medical School: Washington Univ Sch Of Med
Year of Graduation: 1989
Speciality
Orthopedic Surgeon
General Information
Hospital: Depaul
Accepting New Patients: Yes
RateMD Rating
4.3, out of 5 based on 3, reviews.

Data Provided By:
E Glenn Glassman, DDS
(314) 739-8888
2388 Schuetz Rd Ste A55
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Tony Heng-Chi Hsu, DDS
(314) 344-1121
2388 Schuetz Rd Ste 3A-55
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
S Vic Glogovac
(314) 291-7510
12255 De Paul Dr
Bridgeton, MO
Specialty
Hand Surgery

Data Provided By:
Gary Lester Singer, MD
12277 de Paul Dr
Bridgeton, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Cincinnati Coll Of Med, Cincinnati Oh 45267
Graduation Year: 1970

Data Provided By:
Gary Farley, DO
(314) 837-5555
12277 de Paul Dr Ste 100
Bridgeton, MO
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1977
Hospital
Hospital: Depaul Health Center, Bridgeton, Mo
Group Practice: Mid America 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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