Use of nerve conduction studies and the pressure-specified sensory device in the diagnosis of carpal tunnel syndrome.
Sixty-nine patients with signs of carpal tunnel syndrome (CTS) underwent nerve conduction studies (NCS) and testing with the Pressure-Specified Sensory Device (PSSD). A total of 102 tests were performed (28 bilateral). Twenty patients underwent a carpal tunnel release and were retested after 4 to 6 months. The Symptom Severity Score (SSS) was calculated before and after surgery. A control group of 20 hands in 10 asymptomatic volunteers underwent identical testing. The NCS sensitivity was 87% with a specificity of 90% whereas the PSSD sensitivity was 81% with a specificity of 65%. The combined sensitivity of the two tests was 93%. In the operative group the SSS improved from a mean of 3.34 pre-operatively to 1.95 postoperatively. The NCS improved in 19/21 hands whereas the PSSD improved in 16/19 hands. The non-invasive SSS and PSSD can increase the diagnostic yield in CTS, especially when the NCS are normal.
Slutsky
D J
DJ
South Bay Hand Surgery Center, Torrance, CA 90503, USA. d-slutsky@msn.com.
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical; D004568:Electrodiagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011312:Pressure; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds / Q000502:physiology*; D012867:Skin / Q000294:innervation*; D014110:Touch / Q000502:physiology*; D016896:Treatment Outcome