Diagnose Carpal Tunnel Syndrome Sebring FL

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Alfred Robert Massam
(863) 385-3611
133 U.S. 27 North
Sebring, FL
Specialty
Adult Reconstructive Orthopaedic Surgery

Data Provided By:
James B Kendrick, DMD
(863) 385-0452
1747 Sw Lakeview Dr
Sebring, FL
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Diana Deane Carr, MD
(863) 382-7777
131 US Highway 27 N
Sebring, FL
Specialties
Orthopedics
Gender
Female
Education
Medical School: Va Commonwealth Univ, Med Coll Of Va Sch Of Med, Richmond Va 23298
Graduation Year: 1975

Data Provided By:
Jose R Thomas Richards, DO
3750 Emergency Ln
Sebring, FL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hlth Sci, Coll Of Osteo Med, Kansas City Mo 64124
Graduation Year: 1970

Data Provided By:
Claude F Martin, MD
(256) 718-3200
2794 Palo Verde Dr
Avon Park, FL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mc Gill Univ, Fac Of Med, Montreal, Que, Canada
Graduation Year: 1984

Data Provided By:
Vernon R Morris, MD
(863) 386-5555
3201 Medical Way
Sebring, FL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1974

Data Provided By:
Stephen Frank Beissinger, MD
(863) 385-2222
6325 US Highway 27 N Ste 201
Sebring, FL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Pittsburgh Sch Of Med, Pittsburgh Pa 15261
Graduation Year: 1975
Hospital
Hospital: Highlands Reg Med Ctr, Sebring, Fl; Winter Haven Hosp, Winter Haven, Fl; Florida Hosp -Lake Placid, Lake Placid, Fl
Group Practice: Florida Joint & Spine Inst

Data Provided By:
Ashok Sonni, MD
(239) 385-2222
6325 US Highway 27 N Ste 201
Sebring, FL
Specialties
Orthopedics
Gender
Male
Languages
Spanish
Education
Medical School: Bangalore Med Coll, Bangalore Univ, Bangalore, Karnataka, India
Graduation Year: 1974
Hospital
Hospital: Florida Hosp Heartland Div, Sebring, Fl; Highlands Reg Med Ctr, Sebring, Fl
Group Practice: Florida Joint & Spine Inst

Data Provided By:
Juan Carlos Alvarez, MD
(863) 314-4477
PO Box 8027
Sebring, FL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Fl Coll Of Med, Gainesville Fl 32610
Graduation Year: 1996

Data Provided By:
Murphy F McGirt, MD
(305) 743-4811
PO Box 248 1064 E Cornell St
Avon Park, FL
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

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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