Prevalence and predictive factors for bilateral carpal tunnel syndrome by electrodiagnosis: A retrospective study

Abstract

Introduction Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. Patients who have unilateral symptoms are frequently found to have bilateral CTS by electrodiagnostic (EDx) study. We aimed to (a) study the prevalence and identify the predictive factors for bilateral CTS diagnosed by EDx; and (b) develop a model to predict bilateral CTS. Methods The retrospective clinical and EDx data of patients with CTS were collected and analyzed using the Chi-squared test and multiple logistic regression analysis. A model was fitted, and the best cutoff point determined. Calibration and discrimination performance of the model were performed. Results A total of 327 patients with a mean age of 50.0 years were enrolled. Most were women (82.6%), and the most common presenting symptom was hand numbness (93.6%). The median duration of symptoms was 60 days. The prevalence of bilateral CTS was 80.7%. In the multivariate analysis, the predictive factors for bilateral CTS were the presence of bilateral symptoms (AOR 6.7 [95%CI 3.1–14.3]), thenar muscle weakness (AOR 3.9 [95%CI 1.3–11.6]), and age ≥ 45 years (AOR 2.5 [95%CI 1.3–4.6]). The logistic regression model was fitted, and the best cutoff point determined. The area under the receiver operating curve (AUC) was 0.76. The respective optimism-corrected C index and Somers’ D was 0.762 and 0.524. Conclusion The prevalence of bilateral CTS was 80.7%. Our findings suggest bilateral CTS was predicted with adequate diagnostic accuracy by bilateral symptoms, age ≥ 45 years, and thenar muscle weakness.

Is the Duration Of Riding Vespas Related To The Risk Of Carpal Tunnel Syndrome?

“…Continuous compression interrupts blood flow to the endoneurial capillary system, causing changes in the blood-nerve barrier and the development of endoneurial edema (13). As a result, the symptoms of CTS such as numbness, tingling and pain are occurred (14). Therefore, repetitive wrist movement especially in a long period are significant risk factors for CTS incidences (13,15) The driving duration in motorcyclists shows a high risk of carpal tunnel syndrome (9).…”

Common Hand Conditions

“…In a retrospective study from 2021 that included 327 patients, presenting symptoms of CTS typically included numbness (94% of patients with electrodiagnostically proven CTS), pain (58%) in the median nerve distribution (thumb, index and middle fingers, and radial half of the ring finger), and weakness with opposition (16.5%) (Figure 1). Symptoms can awaken patients or progress to persistent numbness. According to a review from 2004, CTS is diagnosed from symptoms and characteristic physical examination signs that include decreased median nerve sensation, thenar muscle wasting or weakness, and provocation of symptoms by holding firm pressure on the carpal tunnel (Durkan test, 64% sensitivity and 83% specificity), holding a 90° flexed wrist position for 20 to 30 seconds (Phalen test, 68% sensitivity and 73% specificity), and firmly and repeatedly tapping at the carpal tunnel (Tinel sign, 50% sensitivity and 77% specificity) …”

Prevalence of Carpal Tunnel Syndrome Symptoms in Excavator Machine Drivers in District Swat, Pakistan

“…Patients with CTS may also present with aches, changes in skin color, and temperature sensitivity. Some patients claim that the thenar muscles have atrophied and weakened interfering with normal hand function (Singjam, Charoentanyarak, and Saengsuwan 2021). In this investigation, we investigated the prevalence of CTS symptoms in excavator machine drivers in the district of Swat, Pakistan.…”