Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.

Abstract : OBJECTIVE: We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. METHODS: We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. RESULTS: The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was <50% for all strategies tested. CONCLUSION: Our study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings.
Type de document :
Article dans une revue
Occup Environ Med, 2010, 67 (2), pp.133-5. 〈10.1136/oem.2009.047431〉
Liste complète des métadonnées

Littérature citée [19 références]  Voir  Masquer  Télécharger

http://www.hal.inserm.fr/inserm-00468698
Contributeur : Nadine Kaniewski <>
Soumis le : mercredi 31 mars 2010 - 13:42:42
Dernière modification le : jeudi 11 janvier 2018 - 06:20:15
Document(s) archivé(s) le : lundi 26 juillet 2010 - 11:45:42

Fichiers

descatha_CTS_shortreport_oem_m...
Fichiers produits par l'(les) auteur(s)

Identifiants

Collections

Citation

Alexis Descatha, Ann-Marie Dale, Alfred Franzblau, Justin Coomes, Bradley Evanoff. Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.. Occup Environ Med, 2010, 67 (2), pp.133-5. 〈10.1136/oem.2009.047431〉. 〈inserm-00468698〉

Partager

Métriques

Consultations de la notice

207

Téléchargements de fichiers

414