Diagnose Carpal Tunnel Syndrome Oskaloosa IA

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Sreedhar Somisetty, MD
410 N 12th St
Oskaloosa, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Osmania Med Coll, Univ Hlth Sci, Vijayawada, Hyderabad, Ap, India
Graduation Year: 1990

Data Provided By:
Sreedhar Somisetty
(641) 672-3360
410 N 12th St
Oskaloosa, IA
Specialty
Orthopedic Surgery

Data Provided By:
Dr. Russell VanHemert
Van Hemert Health Partners P.C.
(641) 628-2099
1310 Washington Street
Pella, IA
Specialty
Chiropractor
Conditions
Back pain,Chronic pain,Leg pain,Lower back pain,Neck pain,Upper back pain
Treatments
Chiropractic adjustment,Chiropractic care,Spinal manipulation

Jeffrey Michael Farber, MD
(515) 247-8400
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1983

Data Provided By:
Robert Douglas Foster, MD
(319) 768-3326
1019 N 7th St
Burlington, IA
Specialties
Orthopedics
Gender
Male
Languages
Spanish
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 1985
Hospital
Hospital: Baxter Reg Med Ctr, Mountain Home, Ar; Washington Reg Med Ctr, Fayetteville, Ar
Group Practice: Ozark Spine & Orthopedic Spec

Data Provided By:
Michael Jos Parks, MD
(517) 437-5399
610 N 12th St Ste B
Oskaloosa, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1976

Data Provided By:
Daniel Wayne Vande Lune, MD
(641) 621-1390
404 Jefferson St Ste L122B
Pella, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1991
Hospital
Hospital: Mahaska County Hosp, Oskaloosa, Ia
Group Practice: Iowa Orthopedics Ctr

Data Provided By:
Dr. Kenneth Van Wyk
Van Wyk Chiropractic Center
(641) 628-3511
911 Washington St
Pella, IA
Specialty
Chiropractor
Conditions
Back pain,Chronic pain,Geriatric care,Leg pain,Lower back pain,Migraine headaches,Neck pain,Neuropathy conditions,Sports injuries,Upper back pain,Whiplash
Treatments
Acupuncture,Chiropractic adjustment,Chiropractic care,DiathermyMyofascialDecompression,Natural healing,Spinal manipulation,Ultrasound
Proffesional Affiliation
Iowa Chiropractic Society (ICS),American Chiropractic Association (ACA)

John Paul Hermanson, DDS
(641) 752-6458
208 E Church St # 103
Marshalltown, IA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
David W Zwanziger, DDS
(319) 277-6976
516 S Division St
Cedar Falls, IA
Specialties
Orthodontics/Dentofacial Orthopedics

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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