Diagnose Carpal Tunnel Syndrome Prattville AL

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Christopher P Piller, MD
(334) 953-7825
Bldg 760 300 S Twinning St
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Duke Univ Sch Of Med, Durham Nc 27710
Graduation Year: 1994

Data Provided By:
Steven Allen Barrington, MD
(334) 274-9000
PO Box 235003
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Vanderbilt Univ Sch Of Med, Nashville Tn 37232
Graduation Year: 1985

Data Provided By:
Thomas George Wells, MD
(334) 263-3944
PO Box 235003
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1969
Hospital
Hospital: Jackson Hosp & Clinic, Montgomery, Al
Group Practice: Alabama Orthopaedic Specs

Data Provided By:
James R Ramey, MD
(334) 280-3456
7859 Hobbie Rd
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Louisville Sch Of Med, Louisville Ky 40202
Graduation Year: 1967

Data Provided By:
James R Ramey III, MD
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Louisville Sch Of Med, Louisville Ky 40202
Graduation Year: 1967

Data Provided By:
Timothy A Holt, MD
(334) 396-1886
PO Box 231509
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Meharry Med Coll Sch Of Med, Nashville Tn 37208
Graduation Year: 1985

Data Provided By:
Charles Wayne Hartzog Jr, MD
(334) 274-9000
PO Box 235003
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1991

Data Provided By:
Donald Davis Thornbury, MD
(334) 274-9000
PO Box 235003
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1978
Hospital
Hospital: Jackson Hosp & Clinic, Montgomery, Al
Group Practice: Alabama Orthopaedic Specs

Data Provided By:
Stephen William Samelson, MD
(334) 613-9000
PO Box 250450
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1992

Data Provided By:
Donald F Hodurski, MD
(334) 613-9000
2000 Normandie Dr
Montgomery, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 1970

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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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