Motor Examination in the Diagnosis of Carpal Tunnel Syndrome
| Autor: | Mithun Neral, Lois Carlson, Ronit Wollstein, Joseph E. Imbriglia |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry Motor testing medicine.disease nervous system diseases body regions Manual Muscle Testing 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation mental disorders medicine Physical therapy Muscle strength Surgery Ulnar nerve Carpal tunnel syndrome Nerve conduction business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Hand and Microsurgery. :067-073 |
| ISSN: | 0974-6897 0974-3227 |
| Popis: | The relative importance and use of motor evaluation to diagnose carpal tunnel syndrome (CTS) is not clear. Because the ulnar nerve is not affected in CTS, we evaluated comparing the strength of the median-nerve innervated muscles to the ulnar innervated muscles in the same patient, through manual muscle testing (MMT) and a handheld dynamometer. Our purpose was to evaluate whether this method, which takes into account patient-dependent factors that would affect both groups of muscles equally, can provide better assessment of CTS. A retrospective case-control review of MMT and dynamometer-measured strength for CTS was performed. The study was performed retrospectively but prior to surgery or other treatment. There were 28 cases (CTS) and 14 controls (without CTS). Positive nerve conduction tests defined cases. MMT of the thenar musculature was found to be unreliable as a test for CTS. Comparisons to ulnar nerve innervated muscle strength did not improve sensitivity or specificity of the MMT examination. Use of the dynamometer improved sensitivity and specificity of motor testing in CTS over MMT. Motor evaluation is important for the diagnosis of CTS, but further study is warranted, specifically to define the method of motor evaluation and delineate the subgroup of patients (predominantly thenar motor presentation) that would benefit most from motor testing and motor-focused treatment. |
| Databáze: | OpenAIRE |
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