Diagnose Carpal Tunnel Syndrome Van Buren AR

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William B Stanton, MD FACS
2722 Highland Cir
Van Buren, AR
Gender
Male
Education
Medical School: Tulane
Graduation Year: 1944

Data Provided By:
Robert Campbell Thompson, MD
(479) 474-8005
2020 Chestnut St Ste 107
Van Buren, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Johns Hopkins Univ Sch Of Med, Baltimore Md 21205
Graduation Year: 1964

Data Provided By:
James Herbert Buie, MD
(479) 709-7000
4500 Towson Ave Ste 101A
Fort Smith, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Tulane Univ Sch Of Med, New Orleans La 70112
Graduation Year: 1961

Data Provided By:
Dr.Joe Alberty
(479) 452-3500
7303 Rogers Avenue
Fort Smith, AR
Gender
M
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
3.5, out of 5 based on 1, reviews.

Data Provided By:
William Morgan Sherrill Jr, MD
(479) 709-7000
101 Phoenix Village Mall
Fort Smith, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tx Southwestern Med Ctr At Dallas, Med Sch, Dallas Tx 75235
Graduation Year: 1970

Data Provided By:
Frankie Martin Griffin, MD
(479) 474-8005
2020 Chestnut St Ste 107
Van Buren, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ar Coll Of Med, Little Rock Ar 72205
Graduation Year: 1991
Hospital
Hospital: Crawford Memorial Hosp, Van Buren, Ar
Group Practice: Complete Orthopaedic

Data Provided By:
Michael Saml Wolfe, MD
(479) 484-4740
PO Box 3528
Fort Smith, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Vanderbilt Univ Sch Of Med, Nashville Tn 37232
Graduation Year: 1978

Data Provided By:
Jeffrey Kevin Evans, MD
(800) 333-1305
7001 Rogers Ave Ste 601
Fort Smith, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ar Coll Of Med, Little Rock Ar 72205
Graduation Year: 1987

Data Provided By:
Robert Gene Bebout, DO
(479) 484-4740
7001 Rogers Ave
Fort Smith, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Hlth Sci, Coll Of Osteo Med, Kansas City Mo 64124
Graduation Year: 1977

Data Provided By:
James J Trusell, DO
(479) 484-4740
7001 Rogers Ave
Fort Smith, AR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1968

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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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