Diagnosis and Clinical Presentation of Carpal Tunnel Syndrome

2020 ◽  
pp. 27-35
Author(s):  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Tunnel Syndrome

Correspondence between clinical presentation and electrophysiological testing for potential carpal tunnel syndrome

2012 ◽  
Vol 38 (5) ◽  
pp. 489-495 ◽  
Author(s):  
H. S. Makanji ◽  
M. Zhao ◽  
C. S. Mudgal ◽  
J. B. Jupiter ◽  
D. Ring
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Pain Catastrophizing ◽  
Future Studies ◽  
Secondary Purpose ◽  
Electrophysiological Testing ◽  
Tunnel Syndrome ◽  
Nerve Dysfunction ◽  
Symptoms And Signs

The diagnosis of carpal tunnel syndrome (CTS) is often applied in the absence of objectively verifiable pathophysiology (i.e. electrophysiologically normal carpal tunnel syndrome). The primary purpose of this study was to determine whether depressive symptoms, heightened illness concern, and pain catastrophizing are associated with an absence of electrophysiological abnormalities. The secondary purpose was to examine the correspondence between the Levine scale, the CTS-6, and electrophysiological abnormalities. Ninety-eight participants completed validated questionnaires assessing psychosocial factors at the initial visit, and surgeons recorded clinical data and their confidence that the diagnosis was carpal tunnel syndrome. Symptoms and signs that are characteristic of carpal tunnel syndrome (e.g. the CTS-6 and Levine scale) significantly, but incompletely coincided with electrophysiological testing. Psychological factors did not help distinguish patients with normal and abnormal objective testing and it remains unclear if symptoms that do not coincide with abnormal tests represent very mild, immeasurable median nerve dysfunction or a different illness altogether. Future studies should address whether outcomes are superior and resource utilization is optimized when surgery is offered based on symptoms and signs (e.g. the CTS-6) or when surgery is offered on the basis of measurable pathophysiology.

Factors involved in the clinical profile of carpal tunnel syndrome

2018 ◽  
Vol 50 (01) ◽  
pp. 8-13 ◽  
Author(s):  
Piotr Puchalski ◽  
Paulina Zyluk ◽  
Zbigniew Szlosser ◽  
Andrzej Zyluk
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Hand Function ◽  
Clinical Profile ◽  
Duration Of Symptoms ◽  
Substantial Impact ◽  
Symptom Scores ◽  
Negative Effect ◽  
Tunnel Syndrome

AbstractClinical presentation of carpal tunnel syndrome may differ in relation to certain factors like sex, age, duration of symptoms and severity of compression. The objective of this study was an investigation into the hypothesis that several distinct factors are predictive of the clinical profile for the condition. The records of 1,117 patients: 909 women (81 %) and 208 men (19 %) with a mean age of 63 years, were analysed. The whole group was divided into subgroups, depending on the variables analysed: sex, age, duration of the condition, severity of symptoms, severity of electrophysiological abnormalities and occurrence or lack of comorbidities. Results. Of all the considered variables, the Levine symptom scores had the greatest impact on the condition’s clinical profile: the higher scores the more severe pain, poorer sensation, weaker grip and worse hand function. Also, ages greater than 80 years had a significant negative effect on most of the considered parameters. None of the remaining analysed variables had a substantial impact on the clinical profile of the condition.

Acute generalised exanthematous pustulosis: an unusual cause of carpal tunnel syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. e235207
Author(s):  
Xuxin Lim ◽  
Kai Yuen Wong
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Skin Biopsy ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Oral Prednisolone ◽  
Steroid Injections ◽  
Histological Assessment ◽  
Tunnel Syndrome ◽  
Exanthematous Pustulosis ◽  
Bilateral Carpal Tunnel Syndrome

A 65-year-old man presented with generalised erythematous pustular rash following an insect bite. He was initially treated with antibiotics for presumed cellulitis. He subsequently developed bilateral carpal tunnel syndrome. Skin biopsy confirmed a diagnosis of acute generalised exanthematous pustulosis, which resolved with oral prednisolone. He also had steroid injections for his bilateral carpal tunnel syndrome and this recovered uneventfully. Clinical presentation, histological assessment and EuroSCAR criteria were key to the diagnosis and management of this case.

scholarly journals CARPAL TUNNEL SYNDROME

2012 ◽  
Vol 19 (01) ◽  
pp. 023-027
Author(s):  
MOHAMMAD SUBHAN ◽  
FARIDULLAH SHAH ◽  
Mohammad TARIQ ◽  
Iftekhar Ali Shah ◽  
Najeeb Ul Haq ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Clinical Presentation ◽  
Standard Of Care ◽  
Tunnel Syndrome ◽  
Age Range

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. The symptoms of CTS include pain,paraesthesia and hypoesthesia in the hand, in the area innervated by the median nerve, and often occurs or worsens during the night or earlymorning, waking the patient up. Physical examination and nerve conduction studies are used to diagnose this condition. Early diagnosis andtreatment of CTS are important because any delay can cause irreversible median nerve damage. Objective: To highlight the role of physicalexamination and nerve conduction study in the diagnosis of CTS. Setting: Kuwait teaching Hospital Peshawar. Period: June 2008 to June2010. Methods: Fifty patients of carpal tunnel syndrome were studied. All patients who reported numbness and/or tingling in the median nervedistribution in the hands at least twice weekly during the preceding four weeks were enrolled to undergo clinical examination and nerveconduction tests. Following the clinical examination the symptomatic persons underwent bilateral nerve conduction tests. Results: Out of thesetwelve patients were males and thirty eight were females with a ratio of 1:3.1. The age range was between 20 to 60 years. CTS was bilateral in 22patients (44%), right-sided in 23(46%) patients and left-sided in 5(10%) patients. Conclusions: In addition to the clinical presentation,electrophysiology has been proposed as the standard of care for diagnosing CTS with a recommendation that it should be performed in allcases.

scholarly journals Recalcitrant Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Jae-Hoo Lee ◽  
Min-Jong Park
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Carpal Tunnel Release ◽  
Persistent Symptom ◽  
Recurrent Symptom ◽  
Proper Management ◽  
Clinical Challenge ◽  
Tunnel Syndrome

Complications and failures after carpal tunnel release have been reported from 3% to 25%. And the revision surgeries usually show poorer outcomes than the primary surgeries. There are diverse etiologies causing neuropathic symptoms after the carpal tunnel release, which became a clinical challenge. Potential causes of the symptoms are categorized into three by those natures; persistent symptom, recurrent symptom, and new symptom. The decision of proper management should be based on the etiologies of reproduced symptoms. This article described an overview of the clinical presentation, etiologies, diagnosis, and treatments of the recalcitrant carpal tunnel syndrome.

Clinical Presentation of Foramen Magnum Meningioma Masqueraded by Carpal Tunnel Syndrome

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Eshagh Bahrami ◽  
Mansour Parvaresh ◽  
Arash Fattahi ◽  
Abdolnaser Farzan ◽  
Foad Kazemi
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Foramen Magnum ◽  
Tunnel Syndrome

scholarly journals Concoradance of clinical and neurophysiologic diagnoses of carpal tunnel syndrome

2015 ◽  
Vol 72 (3) ◽  
pp. 247-250
Author(s):  
Vesna Martic
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
High Specificity ◽  
Evaluation Methods ◽  
Clinical Findings ◽  
Tunnel Syndrome ◽  
Low Sensitivity

Introduction/Aim. Clinical presentation and neurophysiological examination are crucial in diagnosing carpal tunnel syndrome (CTS). The aim of this study was to determine sensitivity and specificity of clinical examination for diagnosing of CTS in relation to neurophysiological evaluation. Methods. The sample included 181 patients referred to the neurologist for further diagnosis of pain and parestesias in the arm (81 women and 100 men mean age 42 ? 14 years and 52 ? 16 years, respectively). All the patients were neurophysiologicly tested. Results. Out of 181 patients, clinical findings were considered positive for CTS in 37 patients. The neurophysiological findings for CTS were positive in 60 patients. Both clinical and neurophysiological findings were positive in 31 patients and both findings were negative in 115 patients (sensitivity 0,51; specificity 0,95). Conclusion. Low sensitivity and high specificity suggest that it is easier to exclude rather than to accurately diagnose CTS based on clinical examination alone. Thus, there is the need for neurophysiological evaluation of patients with complains in the arm.

Sign in / Sign up

Export Citation Format

Share Document