Diagnose Carpal Tunnel Syndrome North Providence RI

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Edward Akelman, MD
(401) 457-1500
2 Dudley St
Providence, RI
Business
University Orthopedics Inc
Specialties
Orthopedics

Data Provided By:
Lawrence W Lee
(401) 459-4001
285 Promenade St
Providence, RI
Specialty
Orthopedic Surgery

Data Provided By:
Eric Paul Launer, MD
(401) 272-9500
955 Chalkstone Ave
Providence, RI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of South Fl Coll Of Med, Tampa Fl 33612
Graduation Year: 1994

Data Provided By:
Dr.Christopher Huntington
(401) 272-9500
955 Chalkstone Avenue
Providence, RI
Gender
M
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ
Year of Graduation: 1990
Speciality
Orthopedic Surgeon
General Information
Hospital: Roger Williams Med Ctr, Providence, Ri
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 2, reviews.

Data Provided By:
Michael E Wiggins
(401) 459-4001
285 Promenade St
Providence, RI
Specialty
Orthopedic Surgery

Data Provided By:
Christopher Fell Huntington
(401) 272-9500
955 Chalkstone Ave
Providence, RI
Specialty
Orthopaedic Surgery of the Spine

Data Provided By:
Christopher F Huntington, MD
(401) 272-9500
955 Chalkstone Ave
Providence, RI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1990
Hospital
Hospital: Roger Williams Med Ctr, Providence, Ri; Our Lady Of Fatima Hosp, N Providence, Ri; St Joseph Health Services, Providence, Ri
Group Practice: Orthopaedic Institute

Data Provided By:
Dr.Joseph A. Izzi Jr
(401) 353-5550
1351 Smith St # 103
North Providence, RI
Gender
M
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
4.5, out of 5 based on 6, reviews.

Data Provided By:
Elizabeth Gail Matzkin, MD
(401) 398-2595
285 Promenade St
Providence, RI
Specialties
Orthopedics
Gender
Female
Education
Medical School: Tulane Univ Sch Of Med, New Orleans La 70112
Graduation Year: 1998

Data Provided By:
Dr.Michael Wiggins
(401) 459-4001
285 Promenade Street
Providence, RI
Gender
M
Education
Medical School: George Washington Univ Sch Of Med & Hlth Sci
Year of Graduation: 1988
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

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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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