Diagnose Carpal Tunnel Syndrome Milledgeville GA

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Steven P Niergarth, DO
(478) 451-0040
1201 N Columbia Dr
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mi State Univ, Coll Of Osteo Med, East Lansing Mi 48824
Graduation Year: 1985

Data Provided By:
Mark Lewis Mudano, MD
(478) 451-0200
541 W Montgomery St Ste 1
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 1984

Data Provided By:
Pedro Luis Tamayo, MD
(478) 452-8096
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Inst Sup De Cien Med De La Habana, La Habana, Cuba
Graduation Year: 1959

Data Provided By:
Akin Omitowoju, MD
2955 N Columbia St
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Lagos, Coll Of Med, Lagos, Nigeria
Graduation Year: 1972

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:
Anne T Sanchez, DMD
(478) 452-7441
1006 Fernwood Dr
Milledgeville, GA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Clarence Hughes Fossier, MD
(478) 457-0037
PO Box 750
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1966

Data Provided By:
John Hopkins Ferguson, DDS
(478) 453-3445
600 N Cobb ST PO Box 850
Milledgeville, GA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert T. Greenfield, III, M.D.
(770) 787-4042
3211 Iris Drive
Covington, GA
Business
Resrugens Orhtopaedics
Specialties
Orthopedics, Adult Spine Surgery, Kyphoplasty, Reconstructive Surgery
Insurance
Insurance Plans Accepted: Accept most plans

Doctor Information
Primary Hospital: Rockdle Medical Center
Residency Training: Howard University College of Medicien
Medical School: Howard University College of Medicine; Washington, D.C.,
Additional Information
Member Organizations: National Medical Association Georgia State Medical Association Atlanta Orthopaedic Society North American Spine Society


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:
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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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