Physical examination has a low yield in screening for carpal tunnel syndrome

Dale, Ann Marie; Descatha, Alexis; Coomes, Justin; Franzblau, Alfred; Evanoff, Bradley

doi:10.1002/ajim.20915

Cited by 20 publications

(17 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subjects were enrolled in the PrediCTS study (2004–2006) as full-time, newly hired workers in construction, service, and clerical jobs. Detailed descriptions of subject recruitment for the PrediCTS study may be found in several prior publications [33, 34, 32, 35]. The present analysis included subjects who completed a follow-up visit between March 2012 and August 2013, consisting of a self-reported questionnaire, physical examination of the upper extremity, and nerve conduction studies of the hands.…”

Section: Methodsmentioning

confidence: 99%

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

et al. 2015

Self Cite

View full text Add to dashboard Cite

Purpose Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. Methods A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. Results All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. Conclusions Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work.

show abstract

Section: Methodsmentioning

confidence: 99%

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…19, 20 Symptoms were classified as “classic” or “probable” using modified scoring of the hand diagram described by Katz et al 17, 18 Abnormal median nerve conduction was defined as sensory latency >3.5 ms (14 cm) OR motor latency >4.5 ms OR median-ulnar sensory latency difference (MUDS) of > 0.5 ms (14 cm). 21 …”

Section: Methodsmentioning

confidence: 99%

Natural History and Predictors of Long-Term Pain and Function Among Workers With Hand Symptoms

Descatha

Franzblau

Evanoff

2013

Archives of Physical Medicine and Rehabilitation

Self Cite

View full text Add to dashboard Cite

Objective To evaluate predictors of hand symptoms and functional impairment after three years of follow-up among workers with different types of hand symptoms including carpal tunnel syndrome (CTS). Functional status and job limitations were also analyzed as key secondary objectives. Design Cohort design of 3-years duration Setting Working population-based study Participants 1107 newly employed workers without a pre-existing diagnosis of CTS. Subjects were categorized into four groups at baseline examination: no hand symptoms, any hand symptoms but not CTS (recurring symptoms in hands, wrist or fingers without neuropathic symptoms), any hand symptoms of CTS (neuropathic symptoms in the fingers and normal nerve conduction study), or confirmed CTS (CTS symptoms and abnormal nerve conduction study). Among workers with hand pain at baseline, subject and job characteristics were assessed as prognostic factors for outcomes, using bivariate and multivariate regression models. Interventions Not applicable Main outcome measure The primary outcome assessed by questionnaire at 3 years was “severe hand pain” in the past 30 days. Results At baseline, 155 workers (17.5% of 888 followed workers) reported hand symptoms, 21 had confirmed CTS. Presence of hand pain at baseline was a strong predictor of future hand pain and job impairment. Subjects with confirmed CTS at baseline were more likely to report severe hand pain, (adjusted prevalence ratios 1.98 [1.11 – 3.52]) and functional status impairment (adjusted prevalence ratios 3.37 [1.01 – 11.29]) than workers with other hand pain. Among subjects meeting our case definition for CTS at baseline, only 4 (19.1%) reported seeing a physician in the 3 year period. Conclusions Hand symptoms persisted among many workers after 3 year follow-up, especially among those with CTS, yet few symptomatic workers had seen a physician.

show abstract

“…CTS is one of the most common entrapment neuropathies of the upper limb [123]. In particular, it is highly related to occupations involving repeated movements and upper limb strength [4].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Related Characteristics of Carpal Tunnel Syndrome Among Orchardists in the Gyeongsangnam-do Region

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo determine the prevalence and related characteristics of carpal tunnel syndrome (CTS) in orchardists and to investigate the association between electrodiagnostic severity and physical examinations.MethodsBetween July 2013 and September 2014, 377 subjects (174 men and 203 women) visited the Gyeongsang National University Hospital's Center for Farmer's Safety and Health. All the subjects underwent electrodiagnostic tests and physical examination, including Phalen's test, Tinel's sign, and Durkan's carpal compression test (CCT). The subjects were classified into 2 groups, the normal group and the CTS group, according to electrodiagnostic test results. To determine the related characteristics of CTS, potential variables, including age, sex, drinking, smoking, body mass index, waist circumference, and total work time, were compared between the 2 groups. The association between electrodiagnostic severity and physical examinations was analyzed.ResultsCTS was diagnosed in 194 subjects based only on electrodiagnostic test results, corresponding to a prevalence of 51.5%. Among the variables, mean age (p=0.001) and total work time (p=0.007) were significantly correlated with CTS. With respect to the physical examinations, low specificities were observed for Tinel's sign, Phalen's test, and Durkan's CCT (38.4%, 36.1%, and 40.9%, respectively) in the subjects aged ≥65 years. In addition, Phalen's test (p=0.003) and Tinel's sign (p=0.032) in men and Durkan's CCT (p=0.047) in women showed statistically significant differences with increasing CTS severity. The odds ratio was 2.066 for Durkan's CCT in women according to the multivariate logistic regression analysis.ConclusionCTS prevalence among orchardists was high, and Durkan's CCT result was significantly quantitatively correlated with the electrodiagnostic test results. Therefore, Durkan's CCT is another reliable examination method for CTS.

show abstract

Physical examination has a low yield in screening for carpal tunnel syndrome

Cited by 20 publications

References 37 publications

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

Natural History and Predictors of Long-Term Pain and Function Among Workers With Hand Symptoms

Prevalence and Related Characteristics of Carpal Tunnel Syndrome Among Orchardists in the Gyeongsangnam-do Region

Contact Info

Product

Resources

About