The Rational Clinical Examination
David L. Simel, Drummond Rennie
Carpal Tunnel Syndrome
Christopher A. D'Arcy, Steven McGee
Sections:
Clinical Scenario, Why Is the Diagnosis Important?, The Diagnostic Standard for Carpal Tunnel Syndrome, Methods, Precision and Accuracy, The Bottom Line, References
Topics Discussed:
carpal tunnel syndrome
Excerpt:
"A 55-year-old woman has difficulty sleeping because of numbness
and tingling in her right hand for 6 months. On a hand diagram,
she uses a pencil to locate precisely her numbness and tingling
over the dorsal and palmar aspects of all 5 fingers, sparing the
palm. On inspection, the patient has no evidence of thenar atrophy,
but thumb abduction is weak on the affected side. Sensory examination result
using monofilaments and a vibrating tuning fork is normal. Tinel
sign is positive and Phalen sign is negative. Which of this patient's
symptoms and signs are useful and which are useless for accurately
predicting the diagnosis of carpal tunnel syndrome (CTS)?..."
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