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Journal articles
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.
Cited literature [19 references]
https://www.hal.inserm.fr/inserm-00468698
Contributor : Nadine Kaniewski <>
Submitted on : Wednesday, March 31, 2010 - 1:42:42 PM
Last modification on : Tuesday, January 19, 2021 - 11:08:22 AM
Long-term archiving on: : Monday, July 26, 2010 - 11:45:42 AM
Contributor : Nadine Kaniewski <>
Submitted on : Wednesday, March 31, 2010 - 1:42:42 PM
Last modification on : Tuesday, January 19, 2021 - 11:08:22 AM
Long-term archiving on: : Monday, July 26, 2010 - 11:45:42 AM
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