Diagnose Carpal Tunnel Syndrome Peru IN

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William Hugo Pohnert, MD
(765) 472-8041
285 W 12th St Ste 106
Peru, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mi Med Sch, Ann Arbor Mi 48109
Graduation Year: 1967
Hospital
Hospital: Howard Comm Hosp, Kokomo, In; St Joseph Mem Hosp, Kokomo, In; Dukes Mem Hosp, Peru, In; Healthsouth Rehabilitation Hos, Kokomo, In
Group Practice: Northcentral Indiana Ortho

Data Provided By:
Jeffrey Francis Granger, MD
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Chicago, Pritzker Sch Of Med, Chicago Il 60637
Graduation Year: 1981

Data Provided By:
Charles Edward Montgomery, MD
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 1969

Data Provided By:
Jeffrey F Granger
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialty
Orthopedic Surgery

Data Provided By:
Thomas M Reilly
(765) 236-8700
311 S Berkley Rd
Kokomo, IN
Specialty
Orthopaedic Surgery of the Spine

Data Provided By:
Aijaz Mohammed Mirza, MD
(260) 569-2408
710 N East St
Wabash, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Dow Med Coll, Univ Of Karachi, Karachi, Pakistan
Graduation Year: 1958
Hospital
Hospital: Wabash County Hosp, Wabash, In
Group Practice: Mirza Orthopedics

Data Provided By:
Charles E Montgomery
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialty
Orthopedic Surgery

Data Provided By:
Jesse Lee Sandlin, MD
(574) 753-4193
1601 Chase Rd
Logansport, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Northeastern Oh Univs Coll Of Med, Rootstown Oh 44272
Graduation Year: 1994

Data Provided By:
Jeffrey Dean Yoder, MD
(765) 868-0313
Medical Office Bldg 200 1907 W Sycamore St
Kokomo, IN
Specialties
Orthopedics
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 1994

Data Provided By:
Kevin T Jarrell, DDS
(765) 453-4261
3905 Southland Ave # A
Kokomo, IN
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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