title: Is needle examination always necessary in evaluation of carpal tunnel syndrome?
abstract: OBJECTIVE
  To investigate whether needle evaluation added any important clinical information to normal nerve conduction studies in the evaluation of carpal tunnel syndromes.
  
  
  METHODS
  Retrospective review of electromyography (EMG) done with the referring diagnosis of possible carpal tunnel syndrome.
  
  
  METHODS
  Outpatients seen for EMG evaluation at one university hospital by a single electromyographer.
  
  
  METHODS
  Consecutive sample of possible carpal tunnel syndrome patients.
  
  
  METHODS
  None.
  
  
  METHODS
  We determined whether needle examination was abnormal when nerve conduction studies were normal.
  
  
  RESULTS
  In patients in whom only carpal tunnel syndrome was suspected, normal nerve conduction studies predicted that EMG would be normal 89.8% of the time (p = .0494). Testing based on a larger sample size might increase the predictive value.
  
  
  CONCLUSIONS
  There may be a subpopulation of patients referred for carpal tunnel syndrome who may be adequately evaluated by nerve conduction studies alone. Additional studies will help evaluate whether this is so.
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Balbierz
authors.forename: A C
authors.initials: AC
authors.lastname: Cottrell
authors.forename: W D
authors.initials: WD
authors.lastname: Cottrell
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D004576:Electromyography; D006225:Hand; D006801:Humans; D008475:Median Nerve / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000294:innervation; D009431:Neural Conduction; D009460:Neurologic Examination; D010808:Physical Examination; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014459:Ulnar Nerve / Q000503:physiopathology