Diagnose Carpal Tunnel Syndrome Mound MN

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Dean Curtis Taylor, MD
(952) 831-8742
Victoria, MN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Duke Univ Sch Of Med, Durham Nc 27710
Graduation Year: 1985

Data Provided By:
James Eugene Johanson, MD
(612) 868-1918
20040 Minnetonka Blvd
Excelsior, MN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mo, Columbia Sch Of Med, Columbia Mo 65212
Graduation Year: 1963

Data Provided By:
Michael W Gleysteen, DDS
(952) 473-7037
250 Central Ave N Ste 113
Wayzata, MN
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Mark Ellis Friedland
(952) 442-2163
501 S Maple St
Waconia, MN
Specialty
Orthopedic Surgery

Data Provided By:
D Daniel Rotenberg, MD
(952) 442-6525
490 S Maple St Ste 203
Waconia, MN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mn Med Sch-Minneapolis, Minneapolis Mn 55455
Graduation Year: 1990

Data Provided By:
Lumir C Proshek, MD
(952) 474-5844
3613 Red Cedar Point Rd
Excelsior, MN
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Mark Todd Wheaton, MD
(952) 593-0500
21920 Minnetonka Blvd
Excelsior, MN
Specialties
Orthopedics
Gender
Male
Education
Medical School: George Washington Univ Sch Of Med & Hlth Sci, Washington Dc 20037
Graduation Year: 1987

Data Provided By:
David Daniel Rotenberg
(952) 442-6525
490 S Maple St
Waconia, MN
Specialty
Orthopedic Surgery

Data Provided By:
Gordon Alvin Welke, MD
(952) 931-9718
Chanhassen, MN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Saskatchewan, Coll Of Med, Saskatoon, Sask, Canada
Graduation Year: 1979
Hospital
Hospital: Fairmont Comm Hosp, Fairmont, Mn
Group Practice: Fairmont Medical Center Mayo Health System; Orthopedic Consultants Chaska Health Center

Data Provided By:
James Philip Wire, MD
(952) 442-8045
204 Lewis Ave S
Watertown, MN
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Univ Of Mn Med Sch-Minneapolis, Minneapolis Mn 55455
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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