Diagnose Carpal Tunnel Syndrome Mitchell SD

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Marcia Nelsen, MD
(605) 996-5903
2200 N Kimball St Ste 1050
Mitchell, SD
Specialties
Orthopedics
Gender
Female
Education
Medical School: Univ Of Sd Sch Of Med, Vermillion Sd, 57069
Graduation Year: 1982
Hospital
Hospital: Sacred Heart Health Services, Yankton, Sd; Sioux Valley Hospital, Sioux Falls, Sd
Group Practice: Praireland Orthopaedics

Data Provided By:
Felix Flores Ungacta, MD
625 N Foster St
Mitchell, SD
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1994
Hospital
Hospital: Sioux Valley Hospital, Sioux Falls, Sd

Data Provided By:
Clark C DuChene
(604) 341-1414
7220 S Highway 16
Rapid City, SD
Specialty
Orthopedic Surgery

Data Provided By:
Jonathan D Watts
(605) 336-2638
2908 E 26th St
Sioux Falls, SD
Specialty
Orthopedic Surgery

Data Provided By:
Steven Jay Meyer
(605) 217-2615
575 N Sioux Point Rd
Dakota Dunes, SD
Specialty
Orthopedic Surgery

Data Provided By:
Robert Ernest Mc Whirter, MD
(605) 996-7077
1222 E 7th Ave
Mitchell, SD
Specialties
Orthopedics, Emergency Medicine
Gender
Male
Education
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduation Year: 1972
Hospital
Hospital: Platte Comm Memorial Hospital, Platte, Sd; Queen Of Peace Hospital, Mitchell, Sd
Group Practice: Mitchell Orthopaedic Ctr

Data Provided By:
H Ray Duncan, DDS
(605) 225-5761
2319 6th Ave SE
Aberdeen, SD
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Dr.JONATHAN WATTS
(605) 336-2638
2908 East 26th Street
Sioux Falls, SD
Gender
M
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
1.0, out of 5 based on 1, reviews.

Data Provided By:
Bradley R Plaga
(605) 331-5890
810 E 23rd St
Sioux Falls, SD
Specialty
Orthopedic Surgery

Data Provided By:
Raymond Lee Emerson
(605) 217-2615
575 N Sioux Point Rd
Dakota Dunes, SD
Specialty
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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