Diagnose Carpal Tunnel Syndrome Portales NM

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Jose H Velez, MD
(505) 762-2223
2301 N Thomas St
Clovis, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Peruana Cayetano Heredia, Prog Acad De Med, Lima, Peru
Graduation Year: 1975

Data Provided By:
Frederick John Hensal, MD
(806) 725-4865
2000 W 21st St Ste J
Clovis, NM
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Anthony F Pachelli, MD
(505) 724-4300
201 Cedar St SE
Albuquerque, NM
Business
New Mexico Orthopaedic Associates
Specialties
Orthopedics

Data Provided By:
Steven Weiner, MD
(505) 982-5014
1630 Hospital Dr
Santa Fe, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Northwestern Univ Med Sch, Chicago Il 60611
Graduation Year: 1970

Data Provided By:
Herbert V Rachelson, MD
(505) 758-8693
5776 Ndcbu
Taos, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kath Univ Leuven, Fac Der Geneeskunde, Leuven, Belgium
Graduation Year: 1971

Data Provided By:
John Dee Bailey, DO
(505) 784-3658
7704 Oklahoma Ct
Clovis, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1990

Data Provided By:
Jacob George, MD
(505) 763-1197
2301 N Thomas St
Clovis, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Seth G S Med Coll, Univ Of Bombay, Bombay, Maharashtra, India
Graduation Year: 1973

Data Provided By:
Robert Leonhard Grossheim, MD
(505) 327-9658
2300 E 30th St Bldg D-101
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mo, Columbia Sch Of Med, Columbia Mo 65212
Graduation Year: 1963
Hospital
Hospital: San Juan Reg Med Ctr, Farmington, Nm
Group Practice: Orthopedic Assoc Pa

Data Provided By:
Dr.Robert Schwartz
(575) 625-2669
350 W Country Club Rd # 103
Roswell, NM
Gender
M
Speciality
Orthopedic Surgeon
General Information
Hospital: Eastern New Mexico Medical Center
Accepting New Patients: Yes
RateMD Rating
4.5, out of 5 based on 2, reviews.

Data Provided By:
Gehron Paul Treme, MD
(505) 272-4107
Albuquerque, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: La State Univ Sch Of Med In New Orleans, New Orleans La 70112
Graduation Year: 2001

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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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