The Sensitivity and Specificity of Tests for Carpal Tunnel Syndrome Vary with the Comparison Subjects

1998 ◽  
Vol 23 (2) ◽  
pp. 151-155 ◽  
Author(s):  
F. GERR ◽  
R. LETZ
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Diagnostic Tests ◽  
Normal Subjects ◽  
Clinical Test ◽  
Test Results ◽  
Electrophysiological Tests ◽  
Tunnel Syndrome ◽  
Electrophysiological Test ◽  
Hand Symptoms

The performance of a variety of common office-based clinical tests for detection of carpal tunnel syndrome (CTS) was assessed in 119 subjects with and without electrophysiological evidence of CTS. Symptoms compatible with CTS and electrophysiological tests positive for median mononeuropathy at the wrist were observed in 57 hands, symptoms compatible with CTS and normal electrophysiological test results were observed in 58 hands, and no symptoms compatible with CTS and normal electrophysiological test results were observed in 123 hands. For all the diagnostic tests studied, the proportion of subjects who had a false positive clinical test result was much higher in the electrophysiologically normal subjects who had CTS compatible hand symptoms than in the electrophysiologically normal subjects who were asymptomatic. These results suggest that many studies that have evaluated diagnostic tests for CTS have produced falsely optimistic estimates of the test’s performance because of their use of asymptomatic comparison subjects.

scholarly journals Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beibei Feng ◽  
Kedi Chen ◽  
Xiaoxia Zhu ◽  
Wing-Yuk Ip ◽  
Lars L. Andersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Computer Use ◽  
Office Workers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Tunnel Syndrome ◽  
Hand Symptoms

Abstract Background Carpal tunnel syndrome (CTS) is a common cause of pain, numbness and tingling in the wrist and hand region and is associated with repetitive wrist and hand use in office workers. However, scarce knowledge exists about the epidemiology of clinically confirmed CTS among Chinese office workers. This study aimed to investigate the prevalence of wrist/hand symptoms and CTS in office workers in China and to identify associated risk factors. Methods A cross-sectional survey was carried out in a metropolitan city in China involving 969 respondents (aged 17–49 years) from 30 workplaces. A questionnaire was distributed to each participant to collect their demographic, work-related physical and psychosocial factors, and wrist and hand symptoms. The wrist and hand pain/numbness symptoms were marked on a body chart and the nature and intensity of symptoms, nocturnal symptoms, as well as aggravating activities were also recorded. Clinically confirmed CTS cases were screened based on the history, Phalen’s test, Tinel Sign and skin sensation testing among symptomatic respondents. Logistic regression was employed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for the occurrence of self-reported wrist and hand symptoms and clinically confirmed CTS. Results The clinically confirmed CTS prevalence was 9.6%. The prevalence of wrist and hand symptoms were 22 and 15%, respectively. Frequently working in pain was associated with higher odds of CTS. Multivariate modelling adjusted for age and gender showed that prolonged computer use time and working without breaks were associated with presence of wrist/hand symptoms (adjusted ORs: 1.11 (95% CI 1.02–1.22) and 1.88 (95% CI 1.12–3.14)). Educational level was inversely associated with CTS and smoking was associated with wrist/hand complaints (adjusted OR: 2.20 (95% CI 1.19–4.07)). Conclusions The prevalence of work-related clinically confirmed CTS symptoms among young office workers in China is high. Frequently working in pain is closely associated with clinically confirmed CTS. Intense computer use and no breaks at work are associated with wrist and hand symptoms.

The Most Important Risk Factors for Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Ali Asghar Sharifi
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Normal Subjects ◽  
Shape Index ◽  
Mean Values ◽  
Tunnel Syndrome ◽  
Independent Risk Factors ◽  
Hand Length

Background: The aim of this study was to determine the risk factors for carpal tunnel syndrome and its relationship with the severity of the disease. Methods: A total of 131 patients with clinical symptoms of CTS and 131 normal subjects were enrolled, of whom 121 were female both in the CTS cases and the controls. All cases were electro diagnostically confirmed and assigned to three severity groups. BMI, wrist ratio, shape index, digit index and hand length/height ratio were measured in all participants. Mean values for each item were compared between cases and controls and severity subgroups. A logistic regression analysis was performed to determine independent CTS risk factors. Results: The mean values of BMI, wrist ratio and shape index were significantly higher in all CTS patients and females compared to controls, whereas in males only BMI and wrist ratio were higher. The patients in the mild severity subgroup had a significantly lower age and wrist ratio. BMI, wrist ratio and shape index were found to be independent risk factors of CTS development in all patients and females. Conclusion: Our study showed BMI, wrist ratio and shape index as independent risk factors for CTS. These findings are important anatomically and clinically and these are the risk factors of anatomical malfunction of the wrist in CTS.

scholarly journals Pressures in the carpal tunnel. A comparison between patients with carpal tunnel syndrome and normal subjects

1990 ◽  
Vol 72-B (3) ◽  
pp. 516-518 ◽  
Author(s):  
S Rojviroj ◽  
W Sirichativapee ◽  
W Kowsuwon ◽  
J Wongwiwattananon ◽  
N Tamnanthong ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Normal Subjects ◽  
Tunnel Syndrome

Forearm, hand, and wrist

2013 ◽  
pp. 1314-1322
Author(s):  
Karen Walker-Bone ◽  
Benjamin Ellis
Keyword(s):  
Rheumatoid Arthritis ◽  
Carpal Tunnel Syndrome ◽  
Soft Tissue ◽  
Musculoskeletal System ◽  
Carpal Tunnel ◽  
Diagnostic Tests ◽  
De Quervain’S Disease ◽  
Vital Part ◽  
Tunnel Syndrome ◽  
Forearm Pain

The forearm, hand, and wrist is a functionally vital part of the musculoskeletal system and in consequence, is highly sophisticated and complex in its anatomical development. Frequently, the hand and wrist may be the site of onset of symptoms of a polyarthropathy such as rheumatoid arthritis or of osteoarthritis, so that the physician should always seek to screen for such conditions before making a local diagnosis. Tenosynovitis, de Quervain’s disease, trigger digit, Dupuytren’s, and carpal tunnel syndrome are local soft tissue pathologies which can usually be discriminated on clinical grounds with or without the use of simple diagnostic tests and are satisfying to treat for the most part. Non-specific forearm pain is more complex, with much controversy surrounding not only its aetiopathogenesis but also its existence. It can be difficult to diagnose and difficult to treat.

scholarly journals Axonal degeneration in association with carpal tunnel syndrome

2003 ◽  
Vol 61 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Marcelo Ribeiro Caetano
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Axonal Degeneration ◽  
Conduction Block ◽  
Sensory Nerve ◽  
Normal Subjects ◽  
Segmental Demyelination ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
Worse Prognosis

Median nerve entrapment in the palm to wrist segment is known as carpal tunnel syndrome (CTS). Electromyography is the best evaluation test to confirm the disease, as it shows a median reduced conduction velocity and/or conduction block; however, the usual CTS electrodiagnostic tests do not separate segmental demyelination alone from segmental demyelination plus secondary axonal degeneration. We studied 100 hands from CTS patients (classified as mild, moderate, and severe), and 50 hands from normal subjects. The median palmar sensory nerve action potential (SNAP) amplitude was measured and compared between the two groups. It would be expected that SNAP was normal if no axonal degeneration had occurred. The results showed that in mild CTS group and part of moderate CTS group SNAP amplitude was normal, whereas in severe CTS group, and part of moderate group SNAP amplitude was reduced, proving that axonal degeneration was involved. As it is well stated that axonal lesions have worse prognosis than segmental demyelinating ones, this simple test may help to preditic the CTS outcome and treatment.

scholarly journals Power Spectral Analyses of Index Finger Skin Blood Perfusion in Carpal Tunnel Syndrome and Diabetic Polyneuropathy

2011 ◽  
Vol 2011 ◽  
pp. 1-8
Author(s):  
Han-Wei Huang ◽  
I-Ming Jou ◽  
Chien-Kuo Wang ◽  
Pei-Yin Chen ◽  
Wen-Chi Wang ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Blood Perfusion ◽  
Diabetic Polyneuropathy ◽  
Test Results ◽  
Doppler Flowmetry ◽  
Frequency Bands ◽  
Skin Blood Perfusion ◽  
Tunnel Syndrome ◽  
Power Dispersion

The main purpose of this study was to investigate the applicability of frequency domain analysis on laser Doppler flowmetry (LDF) data recorded from the index fingers of patients with carpal tunnel syndrome (CTS) and diabetic polyneuropathy (DPN). Patients with numbness of the palm were recruited and grouped according to the results of electrophysiological examinations into 2×2 groups by the existence or nonexistence of CTS and/or DPN. Skin blood perfusion was recorded by LDF in both the neutral position and the maximally flexed position (the Phalen test). -transformation was utilized to decompose the recorded data into frequency bands, and the relative band power and power dispersion were calculated. Analysis of variance was used to test the effects of DPN, CTS, and the Phalen test results. The results showed that (1) DPN decreased the absolute power and the relative power in some frequency bands in both positions and CTS increased the power dispersion of some frequency bands only during the Phalen test and (2) there was no difference in the LDF results between patients with positive or negative Phalen test results.

Exercise as a Prophylactic Device against Carpal Tunnel Syndrome

1989 ◽  
Vol 33 (11) ◽  
pp. 723-727 ◽  
Author(s):  
Thomas L. Williams ◽  
Leo A. Smith ◽  
Richard T. Herrick
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Exercise Program ◽  
Control Group ◽  
Test Results ◽  
Garment Workers ◽  
Liquid Crystal Thermography ◽  
Tunnel Syndrome ◽  
Female Employees ◽  
Garment Manufacturing

The null hupothesis that participation in an on-the-job strength and flexibility exercise program typical of those directed toward prevention of musculoskeletal stress has no prophylactic effect against carpal tunnel syndrome when used as an intervention measure in a population of female garment workers was examined. Grip strength, Phelan's test results, and hand/wrist thermograms obtained by liquid crystal thermography were taken on an experimental group of female employees in a southern garment manufacturing facility before, after five weeks, and after ten weeks of an exercise program and compared with data obtained from a control group. Although the test results suggested the exercise program may have had some benefit, the null hypothesis could not be rejected. An engineering economic analysis, assuming the exercise program was effective and implemented throughout the corporation, indicated the payback period would be approximately eleven years thus casting doubt on its economic efficacy also.

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