The role of electrodiagnostic testing in carpal tunnel syndrome
Electrodiagnostic testing in patients who have upper-extremity symptoms, which may include carpal tunnel syndrome (CTS), has been the gold standard for diagnosis for many years. Depite their value, these tests are underutilized. The authors examined the use patterns of electrodiagnostic testing at the University of Virginia by reviewing the records of the Electromyography Laboratory for the calendar year 1994. Studies in patients with CTS comprised 15% of the 1626 studies performed during that time. The mononeuropathy was mild in the majority of cases and most of the patients were referred for testing by specialists. There was a clear referral bias on the part of the primary care physicians, and the severity of mononeuropathy in the patients they referred for testing was significantly greater than in patients referred by specialists. The data indicate that electrodiagnostic testing has clear value in the evaluation of patients who have upper-extremity symptoms. Despite this fact, primary care physicians appear to underutilize electrodiagnostic testing.