scholarly journals Utilization of Electrodiagnostic Testing for Carpal Tunnel Syndrome by General Practitioners Prior to Hand Surgery Consultation

Hand ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 56-58 ◽  
Author(s):  
Joshua Colombo ◽  
Smiresh Shah
Keyword(s):  
Carpal Tunnel Syndrome ◽  
General Practitioners ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Hand Surgery ◽  
Referral Pattern ◽  
Electrodiagnostic Testing ◽  
Hand Surgeon ◽  
Tunnel Syndrome ◽  
Low Rate

Background:Carpal tunnel syndrome (CTS) is the most common peripheral mononeuropathy and thus is frequently encountered by general practitioners (GPs). The aim of this study is to investigate the referral pattern of GPs with regard to electrodiagnostic (EDX) testing for suspected CTS prior to hand surgery consultation, as well as to investigate the results of EDX testing for suspected CTS when requested by GPs prior to evaluation by a hand surgeon. Methods: We retrospectively reviewed patients referred to our hand surgery clinic over a consecutive 2-year period for suspected CTS. Results: A total of 403 patients were referred to our hand surgery clinic from January 1, 2016, to December 31, 2017. Of the 403, 295 (73.2%) were referred by GPs. GPs obtained prereferral EDX testing in 198 (67.1%) of these patients. EDX testing confirmed their diagnosis in 177 patients (89.4%). There were 21 patients (10.6%) identified with normal EDX testing and a more likely diagnosis reached based on clinical examination. Conclusions: GPs make up the majority of our referrals for CTS, and they obtain EDX testing prior to consultation in two-thirds of referrals. GPs appear to accurately utilize EDX testing to confirm their diagnosis prior to referral and have a low rate of normal testing where symptoms are more readily explained by an alternative diagnosis.

Sono-Elastography in evaluation of the median nerve in carpal tunnel syndrome patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maha Mohamed Abdelraouf ◽  
Amal Ibrahim Ahmed ◽  
Nouran Abdelrahman Elghitany
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Area Under Curve ◽  
University Hospitals ◽  
Electrodiagnostic Testing ◽  
Study Population ◽  
Tunnel Syndrome ◽  
Study Setting

Abstract Background Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. It is caused by compression of the median nerve as it passes through the carpal tunnel in the wrist. The diagnosis of CTS is based on a combination of characteristic symptoms and electrophysiologic abnormalities. Electrodiagnostic testing (EDT) is uncomfortable for patients, time consuming and expensive. Objective To evaluate the role of greyscale and strain elastography ultrasound imaging in diagnosing patients with CTS and controls in comparison with nerve conductive studies. Patients and Methods Type of Study: Descriptive, prospective study. Study Setting: The study will be conducted at Ain Shams University Hospitals, Radiodiagnosis department. Study Period: 6 months. Study Population: Patients with carpal tunnel syndrome diagnosed clinically and underwent nerve conduction velocity study. Results In this study 7 wrists were diagnosed with mild CTS, 5 wrists demonstrated moderate CT, whereas only 3 wrists revealed severe CTS. The mean CSA would have increased if the number of cases with severe CTS had been higher. CSA of the median nerve has been reported to increase with the severity of entrapment. The cut off point of the average CSA to differentiate between cases and controls was found > 8 with sensitivity of 93.33%, specificity of 80% and area under curve (AUC) of 91.3% while the best cut off point for Elasto score was found > 1 with sensitivity of 86.6%, specificity of 80% and area under curve (AUC) of 93.3%. Conclusion We concluded that sonoelastography is a sensitive tool for prediction of CTS and it’s severity in correlation to NCV.

KATZ AND STIRRAT HAND DIAGRAM REVISITED

Hand Surgery ◽  
2010 ◽  
Vol 15 (02) ◽  
pp. 71-73 ◽  
Author(s):  
Rouin Amirfeyz ◽  
Sanchit Mehendale ◽  
Sarah Tyrrell ◽  
Raj Bhatia ◽  
Ian Leslie ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Correlation Coefficient ◽  
Carpal Tunnel ◽  
Observer Agreement ◽  
Healthy Individuals ◽  
Intra Class Correlation ◽  
Hand Surgeon ◽  
Observer Reliability ◽  
Tunnel Syndrome ◽  
Intra Class Correlation Coefficient

Katz and Stirrat devised a hand diagram, which uses subjective information from the patient for the diagnosis of carpal tunnel syndrome (CTS). They reported a good result. We tested the inter-observer and intra-observer reliability of this hand diagram. Twenty five consecutive patients with a diagnosis of CTS, 25 with other common hand and wrist problems but CTS and 25 healthy individuals were prospectively recruited. Each patient filled in a hand diagram. Two experienced hand surgeon scored the diagrams blindly on two different sittings four-week apart. The intra-class correlation coefficient (ICC) and Cohen's Kappa were used for intra and inter-observer reliability respectively. The intra-observer agreement was poor (ICC 95% 0.33–0.65) and inter-observer was fair (Kappa = 0.241). This study does not support the use of Katz and Stirrat Hand Diagram for the diagnosis of carpal tunnel syndrome in place if a thorough clinical examination.

scholarly journals PROFILE OF PATIENTS WITH CARPAL TUNNEL SYNDROME TREATED AT A REFERRAL SERVICE

2020 ◽  
Vol 28 (3) ◽  
pp. 117-120
Author(s):  
HENVER RIBEIRO DE PAIVA FILHO ◽  
VALDÊNIA DAS GRAÇAS NASCIMENTO PAIVA ◽  
ELIAS FELIX DE OLIVEIRA ◽  
MURILO ANTÔNIO ROCHA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Case Series ◽  
Hand Surgery ◽  
Elementary Level ◽  
Level Of Evidence ◽  
Women Smokers ◽  
Referral Service ◽  
Tunnel Syndrome ◽  
Epidemiological Characteristics

ABSTRACT Objective: To describe the clinical and epidemiological characteristics of people diagnosed with carpal tunnel syndrome (CTS) treated at a hand surgery outpatient clinic of a regional referral service. Methods: Interview and specific medical examination of 150 people diagnosed with CTS underwent, and statistical analysis of the results obtained. Results: Women smokers, in the fifth decade of life, married, overweight and educated until the elementary level prevailed in our study. Arterial hypertension and diabetes were the most reported comorbidities, and Durkan’s test was the most prevalent. Conclusion: CTS is prevalent in women in their fifth decade of life, with bilateral involvement and high school. The hypertension and diabetes are the most common diseases in people with CTS. Level of evidence IV, Case series.

scholarly journals Physical Therapy Intervention Following Surgical Treatment of Carpal Tunnel Syndrome in an Individual With a History of Postmastectomy Lymphedema

2002 ◽  
Vol 82 (10) ◽  
pp. 1009-1016 ◽  
Author(s):  
Julie E Donachy ◽  
Emily L Christian
Keyword(s):  
Physical Therapy ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
Tourniquet Time ◽  
Compression Bandaging ◽  
Right Hand ◽  
Tunnel Syndrome ◽  
Chronic Lymphedema

Abstract Background and Purpose. This case report describes the physical therapy examination, intervention, and outcomes for a patient with lymphedema following breast cancer treatment who underwent carpal tunnel release. Case Description. The patient was a 53-year-old woman with right upper-limb lymphedema and symptoms of carpal tunnel syndrome (CTS) in her right hand who underwent a carpal tunnel release. Management of her lymphedema included the use of general anesthesia with reduced tourniquet time in conjunction with physical therapy, which included use of compression bandaging, limb positioning, and exercise. Outcomes. Following surgical release, the patient' s numbness and pain were alleviated. Right-hand grip strength increased following active exercise. Girth of the forearm decreased 1 to 1.5 cm at the 2 most distal measurement sites, and girth of the arm increased 1.5 to 2 cm 6 months after surgery. Discussion. This case supports the option of elective hand surgery for CTS in an individual with chronic lymphedema.

Comparison of Ultrasound and Electrodiagnostic Testing for Diagnosis of Carpal Tunnel Syndrome

2014 ◽  
Vol 96 (17) ◽  
pp. e148 ◽  
Author(s):  
John R. Fowler ◽  
Maria Munsch ◽  
Rick Tosti ◽  
William C. Hagberg ◽  
Joseph E. Imbriglia
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Electrodiagnostic Testing ◽  
Tunnel Syndrome

Co-existing carpal tunnel syndrome in complex regional pain syndrome after hand trauma

2009 ◽  
Vol 35 (3) ◽  
pp. 228-231 ◽  
Author(s):  
S. M. Koh ◽  
F. Moate ◽  
D. Grinsell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Range Of Motion ◽  
Grip Strength ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Pain Scores ◽  
Tunnel Syndrome

This study highlights the benefits of carpal tunnel release (CTR) in four patients presenting with complex regional pain syndrome (CRPS) after hand surgery who also had carpal tunnel syndrome (CTS) diagnosed clinically and by nerve conduction studies. Three of the patients underwent pre- and postoperative volumetric, circumference, grip strength and range of motion measurements. The Disabilities of the Arm, Shoulder and Hand (DASH) functional outcome measure and pain scores were also used. There was almost complete resolution of CRPS symptoms in all four patients, with notable reductions in oedema and improvements in grip strength and range of motion. There were also improvements in DASH outcome scores and pain scores after CTR.

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