AANEM: Three Questions Help Identify Carpal Tunnel Syndrome

Simple screening tool can select referrals for electrodiagnostic screening

WEDNESDAY, Sept. 17 (HealthDay News) -- Asking patients who present with suspected carpal tunnel syndrome just three questions can help identify those who should be referred for electrodiagnostic testing, according to a study presented at the 55th Annual Meeting of the American Association of Neuromuscular and Electrodiagnostic Medicine, held from Sept. 17 to 20 in Providence, R.I.

The study by Simon Podnar, M.D., of the University Medical Centre Ljubljana in Slovenia, and colleagues consisted of a seven-item questionnaire completed by 100 patients with suspected carpal tunnel syndrome who were referred for electrodiagnostic testing. The ideal standard was derived from the results of two nerve conduction studies (median terminal motor latencies - 8 cm, sensory antidromic median - ulnar nerve conduction to the ring finger - 14 cm).

Positive answers to two of three questions regarding tingling in two or more of the first four fingers, worse symptoms at night or on waking, and improvement in symptoms after shaking the hand, accurately predicted an abnormal electrodiagnostic test with a sensitivity of 97 percent, the investigators found.

"A simple questionnaire proved to be a useful screening tool with a high sensitivity for predicting electrodiagnostic abnormalities typical for carpal tunnel syndrome," the authors write. "The three questions…should be used by clinicians in combination with the evaluation of thenar atrophy and sensation in the first three and a half digits before referring patients for electrodiagnostic testing for carpal tunnel syndrome."

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