Diagnose Carpal Tunnel Syndrome Nashua NH

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Ralph Robinson Wolf III, MD
(603) 889-1881
159 Kinsley St
Nashua, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: George Washington Univ Sch Of Med & Hlth Sci, Washington Dc 20037
Graduation Year: 1969

Data Provided By:
Sean Charles lucas Frost
(603) 577-4340
21 E Hollis St
Nashua, NH
Specialty
Orthopedic Surgery, Adult Reconstructive Orthopaedic Surgery

Data Provided By:
Mauro Giordani, MD
(606) 577-4340
21 E Hollis St
Nashua, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Southern Ca Sch Of Med, Los Angeles Ca 90033
Graduation Year: 1984

Data Provided By:
Kathleen Anne Hogan
(603) 883-0091
17 Riverside St
Nashua, NH
Specialty
Adult Reconstructive Orthopaedic Surgery

Data Provided By:
Heather C Killie
(603) 883-0091
17 Riverside St
Nashua, NH
Specialty
Orthopedic Surgery

Data Provided By:
Douglas M Joseph
(603) 883-0091
17 Riverside St
Nashua, NH
Specialty
Orthopedic Surgery

Data Provided By:
William Russell Price, MD
(603) 883-0091
505 W Hollis St Ste 113
Nashua, NH
Specialties
Orthopedics
Gender
Male
Education
Medical School: Tufts Univ Sch Of Med, Boston Ma 02111
Graduation Year: 1984

Data Provided By:
Dr.Anthony Marino
(603) 883-0091
17 Riverside St # 101
Nashua, NH
Gender
M
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
2.2, out of 5 based on 5, reviews.

Data Provided By:
William Russell Price
(603) 883-0091
17 Riverside St
Nashua, NH
Specialty
Orthopedic Surgery

Data Provided By:
Wesley Robert Wallace, MD
(603) 315-9363
21 E Hollis St
Nashua, NH
Specialties
Orthopedics, Medical Management
Gender
Male
Education
Medical School: Suny-Hlth Sci Ctr At Brooklyn, Coll Of Med, Brooklyn Ny 11203
Graduation Year: 1969
Hospital
Hospital: Southern New Hampshire Regiona, Nashua, Nh
Group Practice: Hitchcock Clinic

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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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