Carpal Tunnel Syndrome: Difference between revisions
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This page is currently under construction as part of an EIM project. Please do not edit, but please come back in the near future to check out new information!! | This page is currently under construction as part of an EIM project. Please do not edit, but please come back in the near future to check out new information!! | ||
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'''Original Editor '''- [[User:Kristin Sartore|Kristin Sartore]] | '''Original Editor '''- [[User:Kristin Sartore|Kristin Sartore]] | ||
'''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | '''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | ||
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== Clinically Relevant Anatomy<br> == | == Clinically Relevant Anatomy<br> == | ||
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== Mechanism of Injury / Pathological Process<br> == | == Mechanism of Injury / Pathological Process<br> == | ||
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.<br>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.<ref>Dutton</ref | 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.<br>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.<ref name="Dutton"> Dutton, M. Orthopaedic examination, evaluation, and intervention. New York: McGraw Hill; 2004</ref> | ||
== Clinical Presentation == | == Clinical Presentation == | ||
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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 | 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 name="Flynn et al">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. Fundamentals for the evidence-based clinician. United States:Evidence in Motion; 2008. </ref> | ||
== <br>Outcome Measures<br> == | == <br>Outcome Measures<br> == | ||
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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 == | ||
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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> | ||
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
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<references /> | <references /> | ||
[[Category:Articles]] [[Category:Condition]] [[Category:EIM_Student_Project]] [[Category:Hand]] [[Category:Musculoskeletal/Orthopaedics]][[Category:Wrist]] | [[Category:Articles]] [[Category:Condition]] [[Category:EIM_Student_Project]] [[Category:Hand]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Wrist]] | ||
Revision as of 08:53, 30 June 2009
This page is currently under construction as part of an EIM project. Please do not edit, but please come back in the near future to check out new information!!
Original Editor - Kristin Sartore
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
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.[1]
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)
Recent Related Research (from Pubmed)[edit | edit source]
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1fOfQYMp1QUFVi0ESe5pTtFLtBWFT4G6xWZC7r_FXuF074Ik2|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
