Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome
Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of el...
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Published in: | Egyptian Rheumatology and Rehabilitation Vol. 45; no. 2; pp. 57 - 64 |
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Format: | Journal Article |
Language: | English |
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Cairo, Egypt
The Egyptian Society for Rheumatology and Rehabilitation
01-04-2018
Springer Berlin Heidelberg Wolters Kluwer India Pvt. Ltd Springer Nature B.V SpringerOpen |
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Abstract | Context
There remains no gold standard or even true agreement among clinicians as to
which electrophysiological tests are most important and most relevant particularly in
the mild and early carpal tunnel syndrome (CTS).
Aim
The aim of this study was to determine the sensitivity and specificity of
electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients
with mild CTS.
Patients and methods
This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands)
with symptoms consistent with mild idiopathic CTS, as well as 100 hands from
controls, were clinically examined and underwent EDX evaluation.
Results
The ring-difference and thumb-difference had the highest sensitivity, with the distal
sensory latency (DSL) of the median nerve coming next. Combined sensory index
(CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive
value. Abnormal DSL of the median nerve had the best negative predictive value. In
patients with early and mild CTS and with normal distal motor latency and DSL, the
CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of
these patients.
Conclusion
CSI and its individual components appear as the best EDX tests that help in the
diagnosis of patients with early and mild idiopathic CTS.Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome / |
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AbstractList | Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS. Patients and methods This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation. Results The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients. Conclusion CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS. Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS. Patients and methods This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation. Results The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients. Conclusion CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS. Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS. Patients and methods This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation. Results The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients. Conclusion CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS.Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome / Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS. Patients and methods This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation. Results The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients. Conclusion CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS. ContextThere remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS).AimThe aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS.Patients and methodsThis is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation.ResultsThe ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients.ConclusionCSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS. |
Author | Hijab, Sarah E. Faraj, Sayf E. A. Sina, Muhammad K. Hafiz, Iman A. |
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Cites_doi | 10.1002/mus.20408 10.1016/j.pain.2006.01.034 10.5435/00124635-200906000-00007 10.1016/j.pmr.2014.01.004 10.1197/j.jht.2004.02.015 10.3928/01477447-20160915-04 10.1016/0363-5023(94)90086-8 10.1002/mus.880171219 10.2106/JBJS.O.00476 10.1097/00002060-200209000-00009 10.1016/j.clinph.2006.08.002 10.1016/j.clinph.2006.02.004 10.1001/jama.282.2.153 10.1002/(SICI)1097-4598(199809)21:9<1166::AID-MUS7>3.0.CO;2-5 10.1016/j.clinph.2008.09.019 10.1002/(SICI)1097-4598(199905)22:5<573::AID-MUS4>3.0.CO;2-A 10.1016/j.clinph.2006.01.015 10.1002/mus.20019 10.1002/mus.10002 10.11152/mu.2013.2066.183.tat 10.1097/BCO.0b013e3281fbd418 10.1002/mus.880161215 10.1016/S0266-7681(00)80009-1 10.1002/ajim.20240 10.1227/NEU.0b013e318233868f 10.1002/mus.880151106 10.1053/jhsu.2000.jhsu025a0120 10.1007/s004150070152 10.1016/j.jhsa.2006.04.007 10.1016/S0003-9993(21)01687-7 10.7860/JCDR/2016/20607.8097 |
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Keywords | idiopathic carpal tunnel syndrome electrodiagnosis of median nerve diagnosis of idiopathic carpal tunnel syndrome |
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There remains no gold standard or even true agreement among clinicians as to
which electrophysiological tests are most important and most relevant... Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant... Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant... ContextThere remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant... |
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SubjectTerms | Carpal tunnel syndrome diagnosis of idiopathic carpal tunnel syndrome electrodiagnosis of median nerve idiopathic carpal tunnel syndrome Medical diagnosis Medicine & Public Health Original Article Rehabilitation |
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Title | Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome |
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