Sensitivity of three median‐to‐ulnar comparative tests in diagnosis of mild carpal tunnel syndrome

Uncini, Antonino; DiMuzio, A.; Awad, J.; Manente, G.; Tafuro, M.; Gambi, D.

doi:10.1002/mus.880161215

Cited by 144 publications

(93 citation statements)

References 19 publications

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“…[6] Measurements of median and ulnar-palmar mixed latencies and median/ ulnar-digit IV differential latencies are most widely used methods. [33,34] Uncini et al [35] found sensitivities of measurements of digit IV-wrist median-ulnar differential latencies, median-ulnar palmar mixed latencies, and L-I method to be 77%, 56%, and 10%, respectively. In a study conducted by Preston et al, [24] the corresponding rates of sensitivity were 91%, 97%, and 88%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Lumbrical-interosseous recording technique versus routine electrodiagnostic methods in the diagnosis of carpal tunnel syndrome

Yılmaz

Gündüz

Akyüz

2017

Turk J Phys Med Rehab

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Objectives:We aimed to evaluate the sensitivity of second lumbrical-interosseous (L-I) technique and to compare the results with other electrophysiological methods in patients with carpal tunnel syndrome (CTS). Patients and methods:This cross-sectional study was conducted in an electrophysiology laboratory of a university hospital between January 2003 and January 2004. A total of 102 patients with CTS (174 hands) and 40 healthy controls (80 hands) were included. Median motor nerve conduction studies were obtained with recordings from the abductor pollicis brevis (APB), median sensory nerve conduction studies from digits I-III and at palm-wrist segment (P-W), median-ulnar sensory comparison at digit IV (M-U), and median-radial sensory comparison at digit I (M-R) were along with L-I technique. Results:The highest sensitivities were found in the median sensory conduction velocity across the palm-wrist (88%), and digit I-wrist segments (80%), median motor distal latency over the APB (77%), and L-I study (76%). The specificities of conventional tests were higher than the sensitivity of L-I method (63%).Conclusion: L-I method has a good diagnostic sensitivity in CTS; however, P-W, median sensory nerve conduction velocity at digit I and median distal motor latency are more sensitive than L-I method. Therefore, L-I method can be applied as a supportive technique in the evaluation of patients with CTS.

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Section: Discussionmentioning

confidence: 99%

Lumbrical-interosseous recording technique versus routine electrodiagnostic methods in the diagnosis of carpal tunnel syndrome

Yılmaz

Gündüz

Akyüz

2017

Turk J Phys Med Rehab

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“…Os métodos comparativos de latências são muito úteis, pois aumentam a sensibilidade eletrodiagnóstica; o paciente serve como seu próprio controle com menor influência da idade, temperatura e distância, além de diminuir problema com neuropatia periférica de base [14][15][16] . Carrol 17 , estudando 50 pessoas normais, encontrou DMR até 0,3 ms para 16-39 anos e até 0,4 ms para 40-82 anos, usando-se 2 DP como limite superior de normalidade, latência medida no pico do PAS e distância variando de 67 a 108 mm (média de 85 mm).…”

Section: Discussionunclassified

Síndrome do túnel do carpo: correlação da comparação de latência sensitiva mediano-radial com condução nervosa rotina em 1059 mãos (668 casos)

Kouyoumdjian

1999

Arq. Neuro-Psiquiatr.

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RESUMO -Foram estudados 668 pacientes (1 059 mãos) com síndrome do túnel do carpo (STC) entre janeiro de 1989 e junho de 1996. O critério de seleção e inclusão dos pacientes baseou-se na diferença de latência sensitiva >1,0 ms entre os potenciais de ação sensitivos (PAS) dos nervos mediano e radial após estimulação simultânea no punho e registro no I dedo (diferença mediano-radial, DMR), representando diferença maior que 6 desviospadrão (DP). DMR foi obtida em 125 mãos normais (grupo controle) com limite superior de normalidade de 0,43 ms (média + 2DP). Todos casos tiveram estudo eletrofisiológico bilateral, sendo excluídos casos com cirurgia prévia ou evidência de neuropatia periférica. A idade variou de 17 a 83 anos com média de 47,5 anos; 91,3% eram do sexo feminino. Valor de DMR > 1,0 ms correlacionou-se em 95% dos casos com latência distal motora do nervo mediano >4,25 ms (80 mm) e com latência distal sensitiva punho -II dedo >3,01 ms (VC <46,4 m/s), punho -III dedo >3,14 ms (VC <44,6 m/s) e punho -IV dedo >3,26 ms (VC <42,9 m/s), todos com 140 mm de distância e latência medida no início do PAS. Os resultados estabelecem critérios anormais para o diagnóstico eletrofisiológico de STC em uma população brasileira para condução motora (latência distal motora do nervo mediano) e sensitiva (latência distal sensitiva do nervo mediano para dedos II, III e IV) após DMR >1,0 ms que indica diagnóstico seguro de STC em praticamente 100% dos casos suspeitos. PALAVRAS-CHAVE: síndrome do túnel do carpo, nervo mediano, neuropatia compressiva, mononeuropatia, condução nervosa. Sensory median/radial latency difference versus routine conduction studies in 1059 carpal tunnel syndrome hands (668 cases)ABSTRACT -Between January 1989 and June 1996, 1 059 carpal tunnel syndrome hands (CTS) from 668 patients were studied. None had been previously operated and all had bilateral conduction studies; peripheral neuropathy was excluded. The patients were selected with sensory median/radial difference (MRD) >1.0 ms that strongly supports electrodiagnosis of CTS (standard deviation > 6) after simultaneous stimulation on wrist and recording on thumb. Normal MRD were obtained in 125 hands with upper limit of normality = 0,43 ms (mean + 2SD). The age ranged from 17 to 83 years (mean 47.5) and 91.3% were female. MRD >1.0 ms correlates in 95% with median distal motor latency >4.25 ms (80 mm distance) and with median distal sensory latency to index finger >3.01 ms, middle finger >3.14 ms and ring finger >3.26 ms, all of them 140 mm distance, antidromic and onset-measured. The results have brought new values for the limit of normality in our EMG laboratory since MRD >1.0 ms is very sensitive for CTS diagnosis.

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“…Zgodnie z zalecanym algorytmem postępowania elektrodiagnostycznego (4) w zależności od wyników badania technikami standardowymi wykonywano także dodatkowe, bardziej czułe testy do oceny przewodnictwa we włóknach czuciowych i ruchowych badanych nerwów (5,6).…”

Section: Materiał I Metodyunclassified

Etiological Factors of Carpal Tunnel Syndrome in Subjects Occupationally Exposed to Monotype Wrist Movements

Lewańska¹,

Walusiak‐Skorupa²

2014

Med Pr

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StreszczenieWstęp: Zespół cieśni nadgarstka (ZCN) jest najczęstszą neuropatią kończyn górnych i najczęstszą chorobą przeciążeniową ukła-du mięśniowo-szkieletowego. Powstaje wskutek ekspozycji zawodowej na powtarzalne, monotypowe ruchy w stawach nadgarstka oraz konieczności użycia siły i narażenia na drgania mechaniczne. Celem pracy była ocena czynników etiologicznych zespołu cieśni nadgarstka u osób zawodowo wykonujących monotypowe ruchy w nadgarstku. Materiał i metody: Zbadano 300 chorych (261 kobiet, 39 mężczyzn) o średniej wieku 52 lata (odchylenie standardowe: ±6,93) hospitalizowanych w Klinice Chorób Zawodowych i Toksykologii Instytutu Medycyny Pracy im. prof. J. Nofera w Łodzi z podejrzeniem etiologii zawodowej ZCN. Wyniki: Badanie ujawniło wysoki odsetek chorób i czynników ogólnoustrojowych uczestniczących w patogenezie ZCN (68,7% badanej populacji). Dominowała otyłość (32%), choroby gruczołu tarczowego (28,7%), hormonalna terapia zastępcza i/lub owariektomia (16,3%) i cukrzyca (12%). U 111 pacjentów współistniało co najmniej kilka potencjalnych czynników etiologicznych powyższej neuropatii. Jedynie u 18 chorych (6%) analiza kliniczna i narażenia zawodowego pozwoliły na rozpoznanie choroby zawodowej -zespołu cieśni nadgarstka. Stwierdzono u nich długotrwałe (20,2±9,3 roku) narażenie zawodowe na monotypowe, wymagające dużej siły ruchy w stawach nadgarstka. Wnioski: W badanej grupie dominowały pozazawodowe czynniki etiologiczne ZCN, a u 37% badanych było ich co najmniej kilka. Wśród pacjentów badanych z powodu podejrzenia zawodowej etiologii ZCN, a także u tych z rozpoznanym zawodowo pochodnym ZCN, przeważały osoby zatrudnione w różnych sektorach przemysłu. Wyniki naszej pracy potwierdzają wieloczynnikową etiologię zespołu cieśni nadgarstka -tylko u 6% badanych miała ona uwarunkowania zawodowe. Med. Pr. 2014;65(2):261-270 Słowa kluczowe: zespół cieśni nadgarstka, etiologia zawodowa, pozazawodowe czynniki ryzyka, przemysł, wykonywane zawody Abstract Background: Carpal tunnel syndrome (CTS) is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. Material and Methods: We conducted the retrospective analysis of 300 patients (261 women, 39 men), mean age 52 years (standard deviation: ±6.93) hospitalized with the suspicion of occupational CTS. Results: The study revealed high percentage (68.7%) of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%), thyroid diseases (28.7%), hormone replacement therapy and/or oophorectomy (16.3%) and diabetes mellitus (12%). In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occ...

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Sensitivity of three median‐to‐ulnar comparative tests in diagnosis of mild carpal tunnel syndrome

Cited by 144 publications

References 19 publications

Lumbrical-interosseous recording technique versus routine electrodiagnostic methods in the diagnosis of carpal tunnel syndrome

Lumbrical-interosseous recording technique versus routine electrodiagnostic methods in the diagnosis of carpal tunnel syndrome

Síndrome do túnel do carpo: correlação da comparação de latência sensitiva mediano-radial com condução nervosa rotina em 1059 mãos (668 casos)

Etiological Factors of Carpal Tunnel Syndrome in Subjects Occupationally Exposed to Monotype Wrist Movements

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