Diagnose Carpal Tunnel Syndrome Wichita KS

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Kenneth Jansson
(316) 631-1600
2778 N Webb Rd
Wichita, KS
Business
Advanced Orthopaedics Associates
Specialties
Orthopedics, Sports Medicine, Arthroscopic Surgery
Insurance
Insurance Plans Accepted: Almost all insurance plans accepted.
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes

Doctor Information
Primary Hospital: Kansas Surgery and Recovery Center; Surgicare of Wichita
Residency Training: Wilford Hall USAF Medical Center, Lackland AFB, TX
Medical School: Darthmouth, 1982
Additional Information
Member Organizations: American College of Sports Medicine American Medical Association American Medical Society for Sports Medicine American Orthopaedic Society for Sports Medicine Arthroscopy Association of North America Fellow American Academy of Orthopaedic Surgeo


Data Provided By:
Samuel C Jack, MD FACS
2121 W Maple St
Wichita, KS
Gender
Male
Education
Medical School: Oklahoma
Graduation Year: 1955

Data Provided By:
James Lee Womack
(316) 962-3030
1010 N Kansas St
Wichita, KS
Specialty
Orthopedic Surgery

Data Provided By:
Ryan Mclean Stuckey
(316) 962-3030
1010 N Kansas St
Wichita, KS
Specialty
Orthopedic Surgery

Data Provided By:
Michael P Estivo, DO
(316) 945-9915
731 N McLean Blvd Ste 150
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1985

Data Provided By:
Suhail Akhter Ansari, MD
(413) 221-3078
517 E Douglas Ave Apt 501
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Grant Med Coll, Univ Of Bombay, Bombay, Maharashtra, India
Graduation Year: 1983
Hospital
Hospital: Southwest Med Ctr, Liberal, Ks; Morton County Hosp, Elkhart, Ks; Stevens County Hosp, Hugoton, Ks
Group Practice: Orthopaedic Specialists

Data Provided By:
James Tan Dunlap
(316) 962-3030
1010 N Kansas St
Wichita, KS
Specialty
Orthopedic Surgery

Data Provided By:
Bernard Thaddeus Poole, MD
(316) 264-2806
818 N Emporia St Ste 107
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Coll Dublin, Nat'L Univ Of Ireland, Fac Of Med, Dublin
Graduation Year: 1962

Data Provided By:
Benjamin Davies Young
(316) 962-3030
1010 N Kansas St
Wichita, KS
Specialty
Orthopedic Surgery

Data Provided By:
Brandon Edwin Gough
(316) 962-3030
1010 N Kansas St
Wichita, KS
Specialty
Orthopedic Surgery

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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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