Diagnose Carpal Tunnel Syndrome Sparks NV

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David W Welmerink, DDS
(775) 358-6320
1155 Prater Way
Sparks, NV
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Jeffrey Welling Mast, MD
(775) 359-5757
2345 E Prater Way Ste 303
Sparks, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 1967

Data Provided By:
Mario E Porras, MD
(775) 358-1050
2005 Silverada Blvd Ste 110
Reno, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Nm Sch Of Med, Albuquerque Nm 87131
Graduation Year: 1971

Data Provided By:
Steve Cunningham
(775) 786-1444
845 Aitken St
Reno, NV
Specialty
Orthopedic Surgery

Data Provided By:
Thomas M Fyda
(775) 786-1444
845 Aitken St
Reno, NV
Specialty
Orthopedic Surgery

Data Provided By:
William Richard Ford Jr, MD
(775) 359-5757
2345 E Prater Way Ste 303
Sparks, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1966

Data Provided By:
Kevin J Andrews, DDS
(775) 674-1444
2125 Green Vista Dr Ste 104
Sparks, NV
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Donald Scott Huene, MD
(775) 329-8423
85 Kirman Ave Ste 303
Reno, NV
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Bowman Gray Sch Of Med Of Wake Forest Univ, Winston-Salem Nc 27157
Graduation Year: 1987

Data Provided By:
Digby Maxwell Preston
(775) 786-3380
75 Pringle Way
Reno, NV
Specialty
Orthopedic Surgery, Orthopaedic Surgery of the Spine

Data Provided By:
Jeffrey Danl Webster, MD
(775) 786-3380
75 Pringle Way Ste 912
Reno, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 1986

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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