title: Carpal tunnel syndrome and hand-arm vibration syndrome. A diagnostic enigma.
abstract: OBJECTIVE
  This article serves to draw attention to the risk to workers from repetitive strain and hand-arm vibration in the workplace and to the diagnostic difficulty in distinguishing carpal tunnel syndrome from the sensorineural component of hand-arm vibration syndrome.
  
  
  METHODS
  Journal publications, textbooks on hand-arm vibration, guidelines of the International Standards Organisation, and European Economic Community directives.
  
  
  METHODS
  Recent reports and current standards.
  
  
  CONCLUSIONS
  Carpal tunnel syndrome can be distinguished from hand-arm vibration syndrome if all factors--anatomical, associated physiological and medical conditions, work exposure history, and ulnar nerve involvement--are evaluated. In some circumstances, the conditions may be present together. A correct diagnosis is crucial because surgical intervention is not usually beneficial if hand-arm vibration exposure has been a contributing factor. The further reduction in grip strength may constitute a serious additional handicap for a worker.
authors.affiliation: Department of Occupational and Environmental Health, St Michael's Hospital, Toronto, Ontario.
authors.forename: P L
authors.initials: PL
authors.lastname: Pelmear
authors.forename: W
authors.initials: W
authors.lastname: Taylor
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000503:physiopathology* / Q000628:therapy; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D009784:Occupational Diseases / Q000503:physiopathology* / Q000628:therapy; D013577:Syndrome; D014732:Vibration / Q000009:adverse effects*