FRI0245 The comparison of clinical findings and provocative tests with enmg in carpal tunnel syndrome

AbstractRecords were analysed from the institutional database, including 943 patients (1089 hands) with CTS who were operated on in the authors’ department over a period of four years (2012 to 2015). The diagnosis of CTS was made solely on the basis of clinical findings in 551 patients (58 %); 392 patients (42 %) also had electrodiagnostic tests performed, for various reasons. Patients were followed-up at 1 and 6 months with assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 month assessments. Statistically significant differences were noted in 3-point pinch strength and sensation: however, these were not clinically meaningful. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after electrodiagnostic tests.

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The Pneumatic Compression Test and Modified Pneumatic Compression Test in the Diagnosis of Carpal Tunnel Syndrome

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhse.2007.06.016 ◽

2007 ◽

Vol 32 (6) ◽

pp. 697-699 ◽

Cited By ~ 5

Author(s):

I. TEKEOGLU ◽

A. DOGAN ◽

G. DEMIR ◽

E. DOLAR

Keyword(s):

Carpal Tunnel Syndrome ◽

Compression Test ◽

Carpal Tunnel ◽

High Sensitivity ◽

Diagnostic Value ◽

Clinical Findings ◽

Control Group ◽

Compression Tests ◽

Provocative Test ◽

Tunnel Syndrome

There are no precise criteria for the diagnosis of carpal tunnel syndrome (CTS): the history is useful but the value of the various provocative tests is questionable. The purpose of this study was to examine the diagnostic value of a new provocative test, the ‘modified pneumatic compression test’ in CTS. The study group consisted of 37 patients with 50 symptomatic CTS hands. A control group of 50 healthy volunteers was recruited. The diagnosis was based on a combination of the history, the clinical findings on examination and electrophysiological criteria. Sensitivity for the pneumatic compression and the modified pneumatic compression tests were 68% and 84%, respectively. Specificities for these tests were 97% and 95%, respectively. The modified pneumatic compression test demonstrated high sensitivity and specificity for CTS. This test facilitated the diagnosis and was easy to use. It may reduce referrals for neurophysiology testing, and so reduce costs.

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Carpal tunnel syndrome

Journal of Neurosurgery ◽

10.3171/jns.1983.59.6.1031 ◽

1983 ◽

Vol 59 (6) ◽

pp. 1031-1036 ◽

Cited By ~ 29

Author(s):

Kenneth W. E. Paine ◽

Konstantinos S. Polyzoidis

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Clinical Findings ◽

Transverse Carpal Ligament ◽

Content Type ◽

Detailed Procedure ◽

Flexor Retinaculum ◽

Tunnel Syndrome ◽

Fine Print

✓ The presenting symptomatology and clinical findings of 464 patients with the carpal tunnel syndrome are reviewed. The results of decompression by section of the transverse carpal ligament are presented, with particular reference to the use of the Paine retinaculotome. Approximately 90% of patients achieved very satisfactory results and complications were minimal. The commonest reason for failure is incomplete division of the flexor retinaculum. The detailed procedure is presented.

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P102 Clinical findings in the diagnosis of carpal tunnel syndrome

Clinical Neurophysiology ◽

10.1016/s1388-2457(08)60373-9 ◽

2008 ◽

Vol 119 ◽

pp. S97

Author(s):

Ayşegül Gündüz ◽

Idris Sayilir ◽

Nurten Uzun Adatepe ◽

Ahmet Dirican

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Clinical Findings ◽

Tunnel Syndrome

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Acute Carpal Tunnel Syndrome as a Complication of Oral Anticoagulant Therapy

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(97)80015-0 ◽

1997 ◽

Vol 22 (1) ◽

pp. 50-51 ◽

Cited By ~ 12

Author(s):

P. R. M. BLACK ◽

M. J. FLOWERS ◽

M. SALEH

Keyword(s):

Carpal Tunnel Syndrome ◽

Anticoagulant Therapy ◽

Carpal Tunnel ◽

Conservative Management ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Clinical Findings ◽

Tunnel Syndrome ◽

Acute Carpal Tunnel Syndrome

Acute carpal tunnel syndrome is well recognized in patients with haemophilia and conservative management with factor replacement and temporary splinting is recommended. There have, however, been very few reported cases of acute carpal tunnel syndrome as a complication of oral anticoagulant therapy. We describe such a case in a patient on long-term warfarin anticoagulation, drawing attention to particular features of the history and clinical findings. In contrast to previous reports, we recommend prompt decompression under local anaesthesia and continuation of the anticoagulant therapy.

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MEDIAN NERVE DEFORMATION DURING FINGER MOTION IN CARPAL TUNNEL SYNDROME: CORRELATION BETWEEN NERVE CONDUCTION AND ULTRASONOGRAPHIC INDICES

Hand Surgery ◽

10.1142/s021881041350024x ◽

2013 ◽

Vol 18 (02) ◽

pp. 203-208 ◽

Cited By ~ 4

Author(s):

Yuichi Yoshii ◽

Tomoo Ishii ◽

Shinsuke Sakai

Keyword(s):

Carpal Tunnel Syndrome ◽

Aspect Ratio ◽

Median Nerve ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Correlation Coefficients ◽

Clinical Findings ◽

Cross Sectional ◽

Asymptomatic Volunteers ◽

Tunnel Syndrome

To compare the median nerve deformation indices between carpal tunnel syndrome (CTS) patients and controls, 60 wrists of asymptomatic volunteers and 40 wrists of idiopathic CTS patients were evaluated by ultrasound. CTS was diagnosed through clinical findings and nerve conduction studies. Deformation indices, which were determined by the ratios of the nerve cross-sectional area, perimeter, aspect ratio, and circularity in finger extension and flexion positions, were measured. The deformation indices were compared between patients and controls. The correlation coefficients between distal motor latency and deformation indices were measured in CTS patients. There were significant differences between patients and controls in the deformation indices of perimeter, aspect ratio, and circularity. There was a mild correlation between distal latency and deformation indices of the perimeter and circularity (correlation coefficient 0.315 and 0.342). The deformation indices of perimeter and circularity might be useful to identify the nerve conduction severity of CTS.

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