Diagnose Carpal Tunnel Syndrome Red Lion PA

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Jeremy Mathis, DO
Dallastown, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Ohio Univ, Coll Of Osteo Med, Athens Oh 45701
Graduation Year: 1999

Data Provided By:
Suzette Jimi Song, MD
(717) 848-4800
2339 S George St
York, PA
Specialties
Orthopedics
Gender
Female
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1993

Data Provided By:
Kirk Nicholas Pandelidis, MD
(717) 741-9400
1855 Powder Mill Rd
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Pa State Univ Coll Of Med, Hershey Pa 17033
Graduation Year: 1985

Data Provided By:
Kevin L Stucki, DO
325 S Belmont St
York, PA
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Dean Allen Nachtigall, DO
(717) 846-7846
1779 5th Ave
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hlth Sci, Coll Of Osteo Med, Kansas City Mo 64124
Graduation Year: 1972

Data Provided By:
John C Sefter Jr, DO
(410) 337-7900
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Philadelphia Coll Of Osteo Med, Philadelphia Pa 19131
Graduation Year: 1986

Data Provided By:
Douglas Joseph Hofmann, MD
(717) 848-4800
1855 Powder Mill Rd
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Pittsburgh Sch Of Med, Pittsburgh Pa 15261
Graduation Year: 1982
Hospital
Hospital: York Hospital, York, Pa
Group Practice: Orthopaedic & Spine Specialists Pc

Data Provided By:
Michael F Mitrick, DO
(717) 848-2297
1750 5th Ave
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Chicago Coll Of Osteo Med, Midwestern Univ, Chicago Il 60615
Graduation Year: 1975

Data Provided By:
Thomas Stephen Ryscavage, MD
(717) 741-4653
2200 S George St Ste W2
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1973

Data Provided By:
David Eugene Reinhardt, DO
325 S Belmont St
York, PA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Des Moines Univ, Coll Osteo Med & Surg, Des Moines Ia 50312
Graduation Year: 1993

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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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