Clinical diagnosis of carpal tunnel syndrome: Old tests–new concepts

Miedany, Yasser El; Ashour, Samia; Youssef, Sally; Mehanna, Annie N.; Meky, Fatma A.

doi:10.1016/j.jbspin.2007.09.014

Cited by 89 publications

(66 citation statements)

References 30 publications

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“…Tenar atrofi ve provokatif testlerin değerlendirildiği çalışmalarda ise tenar atrofinin kompresyon şiddeti ile görülmesinde artış olduğu, provokatif testlerin ise kompresyonun şiddetiyle orantılı olarak artan duyu bozukluğu nedeni ile tanıda yararlı olmadıkları, ENMG bulgularını desteklemedikleri bildirilmektedir (23,27,29,30).…”

Section: Bulgularunclassified

Karpal Tünel Sendromlu Hastalarda Kompresyonun Şiddeti ile Klinik Semptomlar, Fiziksel, Fonksiyonel ve Yaşam Kalitesi Bulgularının İlişkisi

Umay¹,

Karaahmet²,

Avluk³

et al. 2011

Tftr

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ÖzetAmaç: Bu çalışmada, elektrofizyolojik olarak karpal tünel sendromu saptanan hastalarda farklı şiddette kompresyon seviyeleri ile klinik semptomlar, fiziksel, fonksiyonel ve yaşam kalitesi bulguları arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntem: Çalışmamıza, kliniğimize elde uyuşma ve ağrı şikayeti ile başvuran ve elektronöromiyografik (ENMG) değerlendirme ile karpal tünel sendromu tanısı alan 65 hasta dahil edildi. Tüm hastaların demografik özellikleri ve mevcut semptomları kaydedildi. Semptomların ciddiyetini değerlendirmede Boston Semptom Ciddiyet Ölçeği (BSCÖ) kullanıldı. Ayrıca hastaların yüzeyel dokunma duyusu, ağrı, ısı duyuları ile iki nokta diskriminasyon testi ile kortikal duyu, tenar atrofi varlığı, Tinel ve Phalen testi, el becerileri, kavrama kuvvetleri, elin fonksiyonelliği ve sağlıkla ilişkili yaşam kalitesi değerlendirildi. Bulgular: Karpal tünel sendromu saptanan 65 hasta ENMG değerlendirme sonuçlarına göre hafif derecede sinir kompresyon bulguları olanlar grup 1 (n=29), orta derece grup 2 (n=18) ve ağır derece grup 3 (n=18) olarak üç gruba ayrıldı. Her üç grup arasında güçsüzlük, beceriksizlik semptomları, semptom ciddiyet ölçeği, duyu fonksiyonları, kavrama kuvvetleri, tenar atrofi varlığı, el fonksiyonları ve ağrı hariç yaşam kalitesi değerlendirme parametreleri bakımından kompresyon şiddeti ile korele olarak olumsuz yönde değişim saptandı. Semptom süresinde uzama ve el becerisinde azalma bakımından sadece grup 1 ve 3 arasında anlamlı farklılık bulundu. Tinel ve Phalen testi pozitifliği ve yaşam kalitesinin ağrı alt ölçeği bakımından ise gruplar arasında farklı bulunmadı. Sum maryOb jec ti ve: In this study, the relationship between different intensities of compression levels and clinical symptoms, physical, functional and qualityof-life findings was investigated in patients with electrophysiologically diagnosed with carpal tunnel syndrome. Metarials and Methods: Sixty five patients who presented with paresthesia and pain in hands and diagnosed as having carpal tunnel syndrome with electroneuromyographic (ENMG) examination were included in our study. Demographic data of all patients and the present symptoms were recorded. The Boston Symptom Severity Scale (BSSS) was used to evaluate the severity of symptoms. In addition, tactile sensation, pain and temperature senses, cortical sensations using static and dynamic two-point discrimination tests, presence of thenar atrophy, Tinel sign and Phalen test, hand dexterity, grip strength, functionality of the hand and health-related quality of life were evaluated. Results: Sixty five patients who were diagnosed with carpal tunnel syndrome were divided into three groups according to the electroneuromyography (ENMG) findings. Patients with mild, moderate and severe median nerve compression were included in group 1 (n=29), Group 2 (n=18) and Group 3 (n=18) respectively. Weakness and clumsiness symptoms, symptom severity scale scores, sensorial functions, grip and pinch strengths, presence of thenar atrophy, hand functions and quality o...

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Section: Bulgularunclassified

Karpal Tünel Sendromlu Hastalarda Kompresyonun Şiddeti ile Klinik Semptomlar, Fiziksel, Fonksiyonel ve Yaşam Kalitesi Bulgularının İlişkisi

Umay¹,

Karaahmet²,

Avluk³

et al. 2011

Tftr

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“…Though physiologic and clinical information have been considered as acceptable tools for CTS diagnosis, due to the low sensitivity, specificity and diagnostic accuracy, these methods are not completely reliable; thus, in case of clinical susceptibility for definitive diagnosis, it is recommended to use Electro-Diagnostic Sensitivity (EDS) methods (De Krom et al, 1990;El Miedany et al, 2008;Macfarlane and Williams, 1990). Ultrasound (US) is an available, non-invasive, cost effective and easy imaging technique that almost has no harm to the body and could be applied for CTS diagnosis (Tai et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasound Findings in Patients with Carpal Tunnel Syndrome

Dehdashti¹,

Kashipazha²,

Rahim³

et al. 2015

J. of Medical Sciences

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Carpal Tunnel Syndrome (CTS) is a common problem that is caused by pressure on a nerve in the wrist and is associated with various factors. We compared Cross-Sectional Area (CSA) of the inlet and outlet in CTS patients and healthy controls and define the best cut off point of CSA and assess the utility of US in the diagnosis of CTS patients as well. This cross-sectional, age-group-matched case-control study was performed on 39 patients aged 42-65 years with electro-physiologically confirmed idiopathic CTS and 35 healthy controls from Golestan Hospital, Ahvaz, Iran from Jan 2013 to Feb 2014. Neurological and electro-diagnostic tests for patients were performed by an expert neurologist as the gold standard diagnostic test for CTS cases. Hundred wrists were evaluated. Electromyography (EMG) showed that 16 (32%) cases were mild, 17 (34%) were moderate and 17 (34%) were severe. The results showed that the CSA of carpal tunnel inlet, carpal tunnel outlet and AP diameter were significantly different between the two groups (p<0.001, p = 0.009, respectively). The sensitivity and specificity of carpal tunnel inlet were 92 and 96%, for carpal tunnel outlet were 92 and 92%, for AP diameter were 64 and 58%. longitudinal evaluations are necessary to better know the utility of ultrasound for diagnosing CTS. The accuracy of diagnosis increases in parallel with the increase in the stages and severity of CTS. Therefore, patients with severe CTS would not need the more uncomfortable, costly and invasive techniques.

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“…Использование при неврологическом осмотре диа-гностических тестов Тинеля, Фалена, дигитальной ком-прессии также имеет невысокую чувствительность и специфичность даже в случае длительно существующей нейропатии [13][14][15]. Методы исследования на этапе фор-мирования заболевания не выявляют нарушения прово-димости импульсов и изменений структуры нерва.…”

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“…«Золо-тым стандартом» диагностики синдрома запястного кана-ла на сегодняшний день остается ЭНМГ. По данным Аме-риканского центра диагностической медицины [4,15], информативность ЭНМГ для туннельных синдромов со-ставляет 49-84%. Используются также ультразвуковая диагностика и магнитно-резонансное исследование.…”

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Electroneurographic monitoring during the test of artificial compression as a method of early diagnosis of carpal tunnel syndrome

Bahtereva

Широков

Leiderman

et al. 2016

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Clinical diagnosis of carpal tunnel syndrome: Old tests–new concepts

Cited by 89 publications

References 30 publications

Karpal Tünel Sendromlu Hastalarda Kompresyonun Şiddeti ile Klinik Semptomlar, Fiziksel, Fonksiyonel ve Yaşam Kalitesi Bulgularının İlişkisi

Karpal Tünel Sendromlu Hastalarda Kompresyonun Şiddeti ile Klinik Semptomlar, Fiziksel, Fonksiyonel ve Yaşam Kalitesi Bulgularının İlişkisi

Diagnostic Accuracy of Ultrasound Findings in Patients with Carpal Tunnel Syndrome

Electroneurographic monitoring during the test of artificial compression as a method of early diagnosis of carpal tunnel syndrome

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