Diagnose Carpal Tunnel Syndrome Menasha WI

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Joseph Edward Pilon, MD
(920) 729-9300
990 Old Plank Road
Menasha, WI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduation Year: 1965

Data Provided By:
David Alan Toivonen, MD
(920) 730-8833
2323 N Casaloma Dr
Appleton, WI
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduation Year: 1989

Data Provided By:
Brian Richard Sears, MD
(920) 725-0077
1516 S Commercial St
Neenah, WI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Oh State Univ Coll Of Med, Columbus Oh 43210
Graduation Year: 1994

Data Provided By:
Brian Richard Sears
(920) 725-0077
1516 S Commercial St
Neenah, WI
Specialty
Orthopedic Surgery

Data Provided By:
Larry Craig Livengood, MD
(920) 730-8833
2323 N Casaloma Dr
Appleton, WI
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Mi State Univ Coll Of Human Med, East Lansing Mi 48824
Graduation Year: 1982

Data Provided By:
James David Kuplic
(920) 731-6611
2105 E Enterprise Ave
Appleton, WI
Specialty
Orthopedic Surgery

Data Provided By:
David Allen Eggert
(920) 731-3111
2105 E Enterprise Ave
Appleton, WI
Specialty
Orthopedic Surgery

Data Provided By:
Sangkyu Han, DDS
(920) 730-0345
4660 W College Ave
Appleton, WI
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Jon J Cherney
(920) 730-8833
2323 N Casaloma Dr
Appleton, WI
Specialty
Orthopedic Surgery

Data Provided By:
Jan Chenette Bax, MD
(920) 730-8833
PO Box 7700
Appleton, WI
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 1980
Hospital
Hospital: Appleton Med Ctr, Appleton, Wi; Theda Clark Reg Med Ctr, Neenah, Wi
Group Practice: Northeast Wisconsin Ctr-Srgry

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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