Diagnose Carpal Tunnel Syndrome Prineville OR

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Dr.Brett Gingold
(541) 388-2333
1315 Northwest 4th Street
Redmond, OR
Gender
M
Education
Medical School: Univ Of Vt Coll Of Med
Year of Graduation: 1997
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 3, reviews.

Data Provided By:
James Roy Karmy, MD
(541) 923-0728
333 NW Larch Ave
Redmond, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1973
Hospital
Hospital: Mountain View Hospital Dist, Madras, Or; Central Oregon District Hosp, Redmond, Or
Group Practice: Redmond Orthopedic Clinic

Data Provided By:
Richard Henry Bolt, MD
(541) 923-4382
3310 NW Tetherow Bridge Loop
Redmond, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1970
Hospital
Hospital: Memorial Hospital At Oconomowo, Oconomowoc, Wi; Waukesha Memorial Hospital, Waukesha, Wi
Group Practice: Orthopaedic Assoc-Waukesha

Data Provided By:
John A Durkan
(541) 386-1818
902 12th St
Hood River, OR
Specialty
Orthopedic Surgery

Data Provided By:
James Christopher Krieg, MD
(503) 249-0719
501 N Graham St Ste 250
Portland, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Umdnj-New Jersey Med Sch, Newark Nj 07103
Graduation Year: 1990

Data Provided By:
Kathleen R Moore, MD
(541) 388-2333
2300 SW Glacier Pl
Redmond, OR
Specialties
Orthopedics
Gender
Female
Education
Medical School: Or Hlth Sci Univ Sch Of Med, Portland Or 97201
Graduation Year: 1989

Data Provided By:
Scot E Burgess, DMD
(541) 923-7432
PO Box 697 710 SW Highland Ave
Redmond, OR
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Donald Orland Warren, MD
(541) 963-8578
700 Sunset Dr Ste F
La Grande, OR
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Univ Of Ks Sch Of Med, Kansas City Ks 66103
Graduation Year: 1974
Hospital
Hospital: Grande Ronde Hospital, La Grande, Or

Data Provided By:
Enoch D Shaw
(503) 480-0485
700 Bellevue St Se
Salem, OR
Specialty
Orthopedic Surgery

Data Provided By:
Michael M Ivanitsky, MD
541-271-2171 x277
600 Ranch Rd
Reedsport, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mayo Med Sch, Rochester Mn 55905
Graduation Year: 1993

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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