The Accuracy of the Scratch Collapse Test Performed by Blinded Examiners on Patients With Suspected Carpal Tunnel Syndrome Assessed by Electrodiagnostic Studies

Simon, Jeremy I.; Lutsky, Kevin; Maltenfort, Mitchell; Beredjiklian, Pedro K.

doi:10.1016/j.jhsa.2017.01.031

Cited by 25 publications

(25 citation statements)

References 13 publications

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“…There are inherent problems with clinicians diagnosing CTS given that the constellation of symptoms and clinical signs of the syndrome, and the available tests are largely unreliable. For example, nocturnal paraesthesias and many classical tests such as Phalen and Tinel, the scratch-collapse and sensory threshold testing have poor diagnostic value 54 , 55 . Despite the widespread use of electrodiagnostic studies in patients with suspected carpal tunnel syndrome, it remains an invasive test which evokes pain and anxiety, and controversy still exists regarding its accuracy and the normal values 56 , 57 .…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of the normal diffusion tensor imaging values of the median nerve and how they change in carpal tunnel syndrome

Rojoa

Raheman

Rassam

et al. 2021

Sci Rep

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Carpal tunnel syndrome (CTS) leads to distortion of axonal architecture, demyelination and fibrosis within the median nerve. Diffusion tensor imaging (DTI) characterises tissue microstructure and generates reproducible proxy measures of nerve ‘health’ which are sensitive to myelination, axon diameter, fiber density and organisation. This meta-analysis summarises the normal DTI values of the median nerve, and how they change in CTS. This systematic review included studies reporting DTI of the median nerve at the level of the wrist in adults. The primary outcome was to determine the normal fractional anisotropy (FA) and mean diffusivity (MD) of the median nerve. Secondarily, we show how the FA and MD differ between asymptomatic adults and patients with CTS, and how these differences are independent of the acquisition methods. We included 32 studies of 2643 wrists, belonging to 1575 asymptomatic adults and 1068 patients with CTS. The normal FA was 0.58 (95% CI 0.56, 0.59) and the normal MD was 1.138 × 10–3 mm2/s (95% CI 1.101, 1.174). Patients with CTS had a significantly lower FA than controls (mean difference 0.12 [95% CI 0.09, 0.16]). Similarly, the median nerve of patients with CTS had a significantly higher mean diffusivity (mean difference 0.16 × 10–3 mm2/s [95% CI 0.05, 0.27]). The differences were independent of experimental factors. We provide summary estimates of the normal FA and MD of the median nerve in asymptomatic adults. Furthermore, we show that diffusion throughout the length of the median nerve becomes more isotropic in patients with CTS.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of the normal diffusion tensor imaging values of the median nerve and how they change in carpal tunnel syndrome

Rojoa

Raheman

Rassam

et al. 2021

Sci Rep

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show abstract

“…There are inherent problems with clinicians diagnosing CTS given that the available tests are largely unreliable. For example, nocturnal paraesthesias and many classical tests such as Phalen and Tinel, the scratch-collapse and sensory threshold testing have poor diagnostic value 54,55 . Despite the widespread use of neurophysiology studies in patients with suspected carpal tunnel syndrome, its diagnostic accuracy is also poor 56 .…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging of the Median Nerve: A Systematic Review and Meta-Analysis of Normal Values in Asymptomatic Adults and How They Change in Carpal Tunnel Syndrome

et al. 2021

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Background: Carpal tunnel syndrome (CTS) leads to distortion of axonal architecture, demyelination and brosis within the median nerve. Diffusion tensor imaging (DTI) characterises tissue microstructure and generates reproducible proxy measures of nerve 'health' which are sensitive to myelination, axon diameter, bre density and organisation. This meta-analysis summarises the normal DTI values of the median nerve, and how they change in CTS.Methods: This systematic review included studies reporting DTI of the median nerve at the level of the wrist in adults. The primary outcome was to determine the normal fractional anisotropy (FA) and mean diffusivity (MD) of the median nerve. Secondarily, we show how the FA and MD differ between asymptomatic adults and patients with CTS, and how these differences are independent of the acquisition methods.Results: 32 studies of 2643 wrists, belonging to 1575 asymptomatic adults and 1068 patients with CTS were included. The normal FA was 0•58 (95% CI 0•56, 0•59) and the normal MD was 1•138 x10 -3 mm 2 /s (95% CI 1•101, 1•174). Patients with CTS had a signi cantly lower FA than controls (mean difference 0•12 [95% CI 0•09, 0•16]). Similarly, the median nerve of patients with CTS had a signi cantly higher mean diffusivity (mean difference 0•16 mm 2 /s x10 -3 [95% CI 0•05, 0•27]). The differences were independent of experimental factors. Conclusion:We provide summary estimates of the normal FA and MD of the median nerve in asymptomatic adults. Furthermore, we show that diffusion throughout the length of the median nerve becomes more isotropic in patients with CTS.

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“…The study by Makanji et al 18 received a rating of low concerns regarding applicability for all domains, but had unclear risk of bias for “index test” and “flow and timing.” It was not clarified whether the index test (SCT) results were interpreted without knowledge of the reference test results and why 7 patients never underwent EMG testing and had to be excluded. The study by Simon et al 19 received a rating of low concerns regarding applicability and low risk of bias for all domains.…”

Section: Discussionmentioning

confidence: 99%

Scratch Collapse Test for Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

Huynh¹,

Karir²,

Bennett³

2018

Plastic and Reconstructive Surgery - Global Open

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Background:Despite the fact that carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, the diagnostic accuracy of clinical screening examinations for CTS is controversial. The scratch collapse test (SCT) is a novel test that may be of diagnostic advantage. The purpose of our study was to determine the diagnostic accuracy of the SCT for CTS.Methods:A literature search was performed using PubMed (1966 to April 2018); Ovid MEDLINE (1966 to April 2018); EMBASE (1988 to April 2018); and Cochrane Central Register of Controlled Trials (The Cochrane Library, to April 2018). We examined the studies for the pooled sensitivity, specificity, and likelihood ratios of the SCT. This review has been registered with PROSPERO (CRD42018077115).Results:The literature search generated 13 unique articles. Seven articles were included for full text screening and 3 articles met our inclusion criteria, all of which were level II evidence with low risk of bias (165 patients). Pooled sensitivities, specificities, positive likelihood ratio, and negative likelihood ratios were 0.32 [95% CI (0.24–0.41)], 0.62 [95% CI (0.45–0.78)], 0.75 [95% CI (0.33–1.67)], and 1.03 [95% CI (0.61–1.74)], respectively. The calculated area under the summary receiver operating characteristic (AUSROC) curve was 0.25, indicating a low diagnostic accuracy.Conclusion:The SCT has poor sensitivity; however, it is moderately specific. Based on the current literature and their variable quality of the evidence, we conclude that the SCT is not an adequate screening test for detecting CTS.

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The Accuracy of the Scratch Collapse Test Performed by Blinded Examiners on Patients With Suspected Carpal Tunnel Syndrome Assessed by Electrodiagnostic Studies

Cited by 25 publications

References 13 publications

Meta-analysis of the normal diffusion tensor imaging values of the median nerve and how they change in carpal tunnel syndrome

Meta-analysis of the normal diffusion tensor imaging values of the median nerve and how they change in carpal tunnel syndrome

Diffusion Tensor Imaging of the Median Nerve: A Systematic Review and Meta-Analysis of Normal Values in Asymptomatic Adults and How They Change in Carpal Tunnel Syndrome

Scratch Collapse Test for Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

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