A Study of Prevalence and Electrophysiological Evaluation in Symptomatic and Asymptomatic Carpal Tunnel Syndrome Among Uka Tarsadia University Students -Observational Study (original) (raw)
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2009
The purpose of this work was to study the degree of accordance between the clinical classification and nerve conduction classification. Also to study the relationship of some suggested risk factors like body mass index (BMI), wrist ratio (WR), and wrist-palm ratio (WPR) to the development of CTS and to the severity of nerve conduction abnormalities in such condition. Clinical assessment and classification for the patient group were done based on the symptoms and signs. According to the clinical classification, patients were classified into 3 groups: mild, moderate and severe. According to nerve conduction classification, the patients were divided into 4 groups: patients with normal conduction, patients with mild conduction abnormality, moderate conduction abnormality, severe conduction abnormality. conclusions: The degree of accordance between the clinical and nerve conduction classification was 52% (discordance = 48%) That increases with the increase in clinical severity. There wer...
Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome
BMC musculoskeletal disorders, 2003
Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS), with a wide range of sensitivity and specificity reported for each test in clinical studies. The tests have not been assessed in population-based studies. Such information would be important when using electrodiagnosis in epidemiologic research. The purpose of this study was to compare the diagnostic accuracy of various nerve conduction tests in population-based CTS and determine the properties of the most accurate test. In a population-based study a questionnaire was mailed to a random sample of 3,000 persons. Of 2,466 responders, 262 symptomatic (numbness/tingling in the radial fingers) and 125 randomly selected asymptomatic responders underwent clinical and electrophysiologic examinations. A standardized hand diagram was administered to the symptomatic persons. At the clinical examination, the examining surgeon identified 94 symptomatic persons as having clinically certain CTS. Nerv...
Archives of Hand and Microsurgery, 2023
This study aimed to correlate the severity of carpal tunnel syndrome (CTS) in terms of the clinical picture with electrophysiological studies to determine whether the severity could be predicted through one measure based on correlations with another. Methods: This cross-sectional correlational study enrolled 96 patients (139 hands) whose nerve conduction studies (NCS) confirmed the diagnosis of CTS, and to whom the Boston Carpal Tunnel Questionnaire (BCTQ) was administered to determine the subjective and clinical CTS severity. The severity of both measures was correlated. Results: The patients' mean age was 49.84±12.23 years. Most (67.7%) were female. The NCS severity grades were as follows: mild, 46%; moderate, 32.4; severe, 9.4%; and very severe, 12.2%. The sensory and motor NCS parameters were significantly correlated with the BCTQ severity. The patients' overall mean scores for symptom severity had substantive predictive accuracy for the patients' CTS severity measured with the NCS. Similarly, most of the functional severity score items had significant predictive accuracy for the patients' NCS-based carpal tunnel severity score. Conclusion: The clinical severity of CTS was strongly correlated with the severity based on nerve conduction. This correlation was more notable for symptom severity scores than for functional status scores. Night pain and numbness demonstrated the strongest associations of all BCTQ items with the NCS. Although clinical severity (based on the BCTQ) predicts the nerve conduction severity, we still recommend performing NCS for patients with a clinical diagnosis of CTS as a confirmatory objective measure and for medico-legal reasons.
Journal of Clinical Neuroscience, 2018
Background: Our study aims to evaluate the reliability of clinical findings in diagnosing carpal tunnel syndrome (CTS), with the help of nerve conduction studies (NCSs) and the detection of comorbidities likely to be risk factors. Methods: 512 patients were included in the study who described pain or paresthesia in the median nerve sensory distribution. Sensory and motor NCSs were performed on the median and ulnar nerves of all patients. 49 patients who showed pathological abnormalities of the ulnar nerve were excluded. Demographic information, clinical findings and comorbidities were recorded. According to the results of the NCSs, the patients were divided and analyzed as either positive and negative for the diagnosis of CTS. Results: The highest sensitivity was seen from the Durkan test (95.6%) and the lowest was from thenar atrophy (22.1%). The highest specificity and positive predictive values were seen for thenar atrophy (100%) and the lowest were from the Tinel test (40.9% and 59.1%). The highest negative predictive value was the Durkan test (94%) and thenar atrophy was the lowest (57.4%). There was a significant difference in NCSs groups for clinical findings and comorbidities. Conclusions: Thenar atrophy and sensory loss were highly specific in CTS but had limited value in early detection. Due to their low specificity, provocative tests do not appear sufficient enough to establish a definite CTS diagnosis. Only Durkan's test could possibly be considered initially as it has more balanced values. Diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout significantly increase the risk of CTS.
Journal of neurosciences in rural practice
The purpose of the study is to determine whether the clinical profile of patients with carpal tunnel syndrome (CTS) has been same over the years with the help of routine and comparative electrodiagnostic tests. A prospective study of 100 patients with suspected CTS was conducted without controls. Three provocative maneuvers were performed. Routine and comparison nerve conduction tests were performed, i.e., second lumbrical interossei motor latency difference (2 LIMLD), digit 4 median-ulnar sensory latency difference (D4MUSLD), palm wrist distal sensory latency difference (PWDSLD), and digit 1 median-radial sensory latency difference (D1MRSLD). Data entry, analysis, and statistical evaluation were done using International Business Machines Corporation Statistical Package for the Social Sciences statistics package (IBM, SPSS). A total of 195 hands of 100 patients met the criteria for CTS. Forty-three percentage of patients were homemakers. Considering the rapidly changing communicatio...
Measurement of nerve conduction study in a sample of healthy Iraqi: Normative data
Electrophysiological study (nerve conduction study " NCS ") is useful adjunct test to the medical history and clinical examination in the diagnosis of such complication, early detection and differentiation of type of peripheral neuropathy. The aims of this study are designed to Decide the most necessary parameters of NCS of healthy subjects to establish the normal electrophysiological values of the common nerves in upper and lower limb .The present study was carried out at the neurophysiology unit in Al-yarmouk Teaching Hospital.The study group consists of eighty six (86) healthy volunteers (45 males and 41 females). The age of this group ranged between 20 to 75 years with a mean (52.48 ±10.63) years. All subjects were healthy and symptoms free, with no history of systemic and neurological diseases. No history of alcohol abuse or drug intake. They compromised normal relatives, medical staff, students and workers. All of 86 subjects that were included in this study were informed about the aim and technique of the study and their acceptance was taken. Each subject was submitted to medical history and electrophysiological tests (NCS) of the two limbs i.e. the upper and the lower. These tests include Sensory nerve conducting study (SNCS) for Median, Ulner and Sural nerves and Motor nerve conducting study (MNCS) for Median, Ulnar, Fibular (Common peroneal), and tibialnerves. The results showed data were processing separately between males and females with mean accompanying with standard deviation for sensory and motor of median, ulnar sural, common peroneal and tibialnerves. Conclusion: The study will be helpful normative parameters of the common tested nerves of the upper and lower limbs were established for the EMG laboratory in our region.
Open Journal of Therapy and Rehabilitation, 2014
This service evaluation and pilot study was designed to establish whether a clinical questionnaire could be incorporated within our Secondary Care Carpal Tunnel Service. The purpose of the questionnaire is to predict the positive and negative results of Nerve Conduction Studies (NCS) in those patients with suspected Carpal Tunnel Syndrome. The hand specialist, preceding NCS administered the questionnaire; it was then scored at a later date. Results showed a sensitivity of 86% and specificity of 84% referring to the ability to predict a positive NCS when using a predetermined cutoff score. When analysed with Receiver Operating Characteristics, a threshold score could be determined in order to obtain 100% sensitivity/specificity. This questionnaire can be used as a useful adjunct to assessment of those presenting with suspected Carpal Tunnel Syndrome. Using the questionnaire to identify those patients scoring outside a predetermined threshold range would reduce the need for NCS by nearly 50%, with significant cost and clinical practice implications.
The Journal of the American Board of Family Medicine, 2007
Nerve conduction studies (NCS) are increasingly being performed at the point-of-service by family medicine, primary care, and internal medicine (FM/PCP/IM) physicians. Carpal tunnel syndrome (CTS) is a common neuropathy often diagnosed with the aid of NCS. Methods: A retrospective analysis of a point-of-service NCS data registry was conducted; 1190 patients who underwent NCS by 613 FM/PCP/IM physician practices, for evaluation of CTS were analyzed. Utility measures included demographic and electrophysiological characteristics of study population, adherence to evidence-based testing guidelines, and relevance of diagnostic outcomes. Results: Tested patients tended to be over 40, female, and overweight or obese. The median nerve distal motor latency was 4.4 ؎ 1.2 ms; 92.6% of studies met the testing guideline; 30.5% of tested limbs yielded normal results; 53.1% CTS; 5.4% ulnar neuropathy; and 11.0% nonspecific upper extremity neuropathy. Discussion: This study demonstrated that point-of-service NCS by FM/PCP/IM physicians for CTS was applied to appropriate patient subpopulations, was performed in accordance with evidence-based testing parameters, and generated relevant diagnostic outcomes.