In the epidemiological studies, median NCSs should be considered desirable, if not essential, for confirming a clinical diagnosis, most of all in the longitudinal studies. In the future of CTS diagnosis, attention should be paid to the electrodiagnostic reference values that are discriminating to confirm the presence or not of the disease.

Given the importance of the dominant hand in working populations, these data support use of SCV-WP (or WSL) as an informative NCS parameter for occupational studies on CTS.

The Crimean Congo Haemorrhagic Fever (CCHF) is a viral infection caused by the CCHF virus (CCHFV), a member of the family Bunyaviridae, genus Nairovirus

Objective: To explore the possible role of ultrasonography in case definitions for epidemiological studies of work-related wrist tenosynovitis. Methods: Clinical and ultrasonography (7.5 MHz linear probe) data systematically collected from meat workers (n = 128) with biomechanical exposure characterisation were analysed. The diagnostic accuracy of different combinations of potentially relevant ultrasonography findings (nonhomogeneity, thickening and anechoic halo) was evaluated using symptomatology as a reference standard. The concordance between ultrasonography findings and symptoms was then analysed. Results: Analysis of wrist biomechanical exposure was suggestive of increased prevalence of musculoskeletal disorders. Using symptoms as a reference standard, each of the three ultrasonography findings (and their combinations) showed good specificity (>85%) accompanied by low sensitivity (,60%); the positive likelihood ratio for at least two findings was 4.1. k Values (95% confidence intervals) between symptoms and different sets of ultrasonography findings were as follows: for non-homogeneity, k = 0.31 (0.19 to 0.43); at least one finding, k = 0.28 (0.16 to 0.40); at least two findings, k = 0.32 (0.20 to 0.44); all p,0.01. Conclusion:The use of ultrasonography in symptomatic subjects could contribute to a more specific epidemiological case definition of wrist tenosynovitis. The results of this study could help orient future research in this direction.T enosynovitis of the wrist (also known as wrist tendinopathy or wrist tendinitis) commonly accompanies forceful and repetitive wrist-hand activities, especially when associated with awkward wrist posture. Epidemiological studies of wrist tenosynovitis commonly use clinical case definitions based on symptoms, sometimes in conjunction with physical signs and clinical history.1-9 Results can be affected by the choice of case definition and the validity of the diagnostic techniques. 10However, the symptoms and physical signs associated with the wrist are not specific, and further investigation is needed to form a reliable case definition for epidemiological studies. 11-15Portable high-resolution (7-15 MHz) ultrasound transducers allow dynamic examination of tendons and can provide a rapid, relatively inexpensive non-invasive imaging tool suitable for epidemiological studies. Ultrasonography is now an elective means to study tendons, sheaths and many of their pathological changes (infective, rheumatic or traumatic inflammation; partial or entire ruptures; effects of diabetes and other degenerative disorders). [16][17][18] However, the role of ultrasonography in the epidemiological classification of overuse tenosynovitis, including acute and degenerative changes, is yet to be clearly defined.To investigate the possible role of high-resolution ultrasonography in case definitions for epidemiological studies of wrist tenosynovitis, we analysed data collected for this purpose from a population of meat workers highly exposed to biomechanical risk factors. We first used the pre...

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