Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies. - Archive ouverte HAL Access content directly
Journal Articles Occup Environ Med Year : 2010

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

(1, 2) , (2) , (3) , (2) , (2)
1
2
3

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.
Fichier principal
Vignette du fichier
descatha_CTS_shortreport_oem_manuscript_Onlinefirst.pdf (259.04 Ko) Télécharger le fichier
Vignette du fichier
inserm-00468698_edited.pdf (109.29 Ko) Télécharger le fichier
Origin : Files produced by the author(s)
Origin : Files produced by the author(s)
Loading...

Dates and versions

inserm-00468698 , version 1 (31-03-2010)

Identifiers

Cite

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⟩
126 View
419 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More