Carpal Tunnel Syndrome: Difference between revisions
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== Clinically Relevant Anatomy<br> | == Clinically Relevant Anatomy<br> == | ||
add text here relating to '''''clinically relevant''''' anatomy of the condition<br> | add text here relating to '''''clinically relevant''''' anatomy of the condition<br> | ||
== Mechanism of Injury / Pathological Process<br> == | == Mechanism of Injury / Pathological Process<br> == | ||
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== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Median nerve conduction study and EMG study are two diagnostic test that can be performed to diagnosis CTS. <br>Tinel’s sign and Phalen’s test are two special test that can be performed in the clinic to help diagnose. Wainner et al developed a clinical perdiction rule to help test for the presence of CTS. The rule consist of 5 predictor variables: Age greater than 45, patient reports shaking hands relieves symptoms, wrist ratio index >.67, reduced median sensory field of the first digit, and Symptom Severity Scale score >1.9.<ref>Flynn et al.</ref> | Median nerve conduction study and EMG study are two diagnostic test that can be performed to diagnosis CTS. <br>Tinel’s sign and Phalen’s test are two special test that can be performed in the clinic to help diagnose. Wainner et al developed a clinical perdiction rule to help test for the presence of CTS. The rule consist of 5 predictor variables: Age greater than 45, patient reports shaking hands relieves symptoms, wrist ratio index >.67, reduced median sensory field of the first digit, and Symptom Severity Scale score >1.9.<ref>Flynn et al.</ref> | ||
== <br>Outcome Measures<br> == | == <br>Outcome Measures<br> == | ||
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Outcome Measures Symptom Severity Scale | Outcome Measures Symptom Severity Scale | ||
DASH - Disability of arm, shoulder and hand | DASH - Disability of arm, shoulder and hand | ||
== Management / InterventionsConservative == | == Management / InterventionsConservative == | ||
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== Differential Diagnosis<br> == | == Differential Diagnosis<br> == | ||
Differential diagnosis for CTS includes cervical radiculopathy, thoracic outlet syndrome, pronator syndrome, wrist joint arthritis, tendonitis, and fibrositis.<ref name="Dutton" /> | Differential diagnosis for CTS includes cervical radiculopathy, thoracic outlet syndrome, pronator syndrome, wrist joint arthritis, tendonitis, and fibrositis.<ref name="Dutton" /> | ||
== Key Evidence == | == Key Evidence == | ||
add text here relating to key evidence with regards to any of the above headings<br> | add text here relating to key evidence with regards to any of the above headings<br> | ||
== Resources == | == Resources == | ||
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Dutton, M. Orthopaedic examination, evaluation, and intervention. New York: McGraw Hill; 2004.<br> | Dutton, M. Orthopaedic examination, evaluation, and intervention. New York: McGraw Hill; 2004.<br> | ||
Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. Fundamentals for the evidence-based clinician. United States:Evidence in Motion; 2008. | Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. Fundamentals for the evidence-based clinician. United States:Evidence in Motion; 2008. | ||
== Case Studies == | == Case Studies == | ||
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== References == | == References == | ||
Revision as of 03:22, 30 June 2009
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Clinically Relevant Anatomy
[edit | edit source]
add text here relating to clinically relevant anatomy of the condition
Mechanism of Injury / Pathological Process
[edit | edit source]
Carpal Tunnel Syndrome (CTS) is a cause of functional impairment and chronic wrist pain of the hand. It results from compression of the median nerve as it passes through the carpal tunnel. An increase in synovial fluid pressure and tendon tension can cause compression of the median nerve in the carpal tunnel.
The compression of the median nerve may results from numerous factors, several of which can easily be remembered by using the mnemonic PRAGMATIC: Pregnancy secondary to fluid retension, Renal dysfunction, Acromegaly, Gout and pseudogout, Myxedema or mass, Amyotrophy, Trauma, Infection, and Collagen disorders.[1]
Clinical Presentation[edit | edit source]
The clinical features of this syndrome include intermittent pain and paresthesias in median nerve distribution of the hand, muscle weakness, and night pain
Diagnostic Procedures[edit | edit source]
Median nerve conduction study and EMG study are two diagnostic test that can be performed to diagnosis CTS.
Tinel’s sign and Phalen’s test are two special test that can be performed in the clinic to help diagnose. Wainner et al developed a clinical perdiction rule to help test for the presence of CTS. The rule consist of 5 predictor variables: Age greater than 45, patient reports shaking hands relieves symptoms, wrist ratio index >.67, reduced median sensory field of the first digit, and Symptom Severity Scale score >1.9.[2]
Outcome Measures
[edit | edit source]
Outcome Measures Symptom Severity Scale
DASH - Disability of arm, shoulder and hand
Management / InterventionsConservative[edit | edit source]
Managment includes use of splints, activity modification, pt education, diuretics, and NSAIDs
Differential Diagnosis
[edit | edit source]
Differential diagnosis for CTS includes cervical radiculopathy, thoracic outlet syndrome, pronator syndrome, wrist joint arthritis, tendonitis, and fibrositis.[3]
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources [edit | edit source]
Dutton, M. Orthopaedic examination, evaluation, and intervention. New York: McGraw Hill; 2004.
Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. Fundamentals for the evidence-based clinician. United States:Evidence in Motion; 2008.
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
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