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Reference: Ntani, G, Palmer, KT, Linaker, C et al., (2013). Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome. BMC musculoskeletal disorders, 14 (1), 242.Citable link to this page:

 

Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome.

Abstract: BACKGROUND: To inform the clinical management of patients with suspected carpal tunnel syndrome (CTS) and case definition for CTS in epidemiological research, we explored the relation of symptoms and signs to sensory nerve conduction (SNC) measurements. METHODS: Patients aged 20-64 years who were referred to a neurophysiology service for investigation of suspected CTS, completed a symptom questionnaire (including hand diagrams) and physical examination (including Tinel's and Phalen's tests). Differences in SNC velocity between the little and index finger were compared according to the anatomical distribution of symptoms in the hand and findings on physical examination. RESULTS: Analysis was based on 1806 hands in 908 patients (response rate 73%). In hands with numbness or tingling but negative on both Tinel's and Phalen's tests, the mean difference in SNC velocities was no higher than in hands with no numbness or tingling. The largest differences in SNC velocities occurred in hands with extensive numbness or tingling in the median nerve sensory distribution and both Tinel's and Phalen's tests positive (mean 13.8, 95% confidence interval (CI) 12.6-15.0 m/s). Hand pain and thumb weakness were unrelated to SNC velocity. CONCLUSIONS: Our findings suggest that in the absence of other objective evidence of median nerve dysfunction, there is little value in referring patients of working age with suspected CTS for nerve conduction studies if they are negative on both Tinel's and Phalen's tests. Alternative case definitions for CTS in epidemiological research are proposed according to the extent of diagnostic information available and the relative importance of sensitivity and specificity.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Publisher's version Funder: Colt Foundation   Notes:© 2013 Ntani et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bibliographic Details

Publisher: BioMed Central Ltd.

Publisher Website: http://www.biomedcentral.com/

Journal: BMC musculoskeletal disorderssee more from them

Publication Website: http://www.biomedcentral.com/bmcmusculoskeletdisord/

Issue Date: 2013

pages:242Identifiers

Urn: uuid:98856e1a-9da0-4513-9bac-055e972f4522

Source identifier: 430389

Eissn: 1471-2474

Doi: https://doi.org/10.1186/1471-2474-14-242

Issn: 1471-2474 Item Description

Type: Journal article;

Language: eng

Version: Publisher's versionKeywords: Humans Median Nerve Hand Pain Hypesthesia Carpal Tunnel Syndrome Neurologic Examination Pain Measurement Questionnaires Predictive Value of Tests Sensation Unnecessary Procedures Adult Middle Aged Neural Conduction Sensory Receptor Cells Young Adult Referral and Consultation Tiny URL: pubs:430389

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Author: Ntani, G - - - Palmer, KT - - - Linaker, C - - - Harris, EC - - - Van der Star, R - - - Cooper, C - institutionUniversity of Oxfo

Source: https://ora.ox.ac.uk/objects/uuid:98856e1a-9da0-4513-9bac-055e972f4522



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