Diagnose Carpal Tunnel Syndrome Waterbury CT

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Joseph C Wu, MD
(203) 752-3100
60 Temple St
New Haven, CT
Business
Center for Orthopaedics PC
Specialties
Orthopedics

Data Provided By:
Glenn Taylor
(203) 755-6677
500 Chase Pkwy
Waterbury, CT
Specialty
Orthopedic Surgery

Data Provided By:
Michael G Sermer
(203) 755-0163
1211 W Main St
Waterbury, CT
Specialty
Orthopedic Surgery

Data Provided By:
Robert P Hendrikson
(203) 755-9166
60 Westwood Ave
Waterbury, CT
Specialty
Orthopedic Surgery

Data Provided By:
Paul Joseph Beauvais, MD
(203) 755-9166
60 Westwood Ave Ste 300
Waterbury, CT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Columbia Univ Coll Of Physicians And Surgeons, New York Ny 10032
Graduation Year: 1990
Hospital
Hospital: St Marys Hosp, Waterbury, Ct; Waterbury Hosp, Waterbury, Ct
Group Practice: Center For Hand Surgery

Data Provided By:
Robert Peter Hendrikson, MD
(203) 755-9166
60 Westwood Ave
Waterbury, CT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1977

Data Provided By:
Andrew J Nelson
(203) 755-7115
1320 W Main St
Waterbury, CT
Specialty
Hand Surgery

Data Provided By:
Stanley Foster
(203) 757-0583
1389 W Main St
Waterbury, CT
Specialty
Hand Surgery

Data Provided By:
Michael Sermer, MD
(203) 755-0163
1211 W Main St
Waterbury, CT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Toronto, Fac Of Med, Toronto, Ont, Canada
Graduation Year: 1975

Data Provided By:
Eric Jon Olson
(203) 755-0163
1211 W Main St
Waterbury, CT
Specialty
Orthopedic Surgery, Sports Medicine

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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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