Diagnostic Strategies Using Physical Examination Are Minimally Useful in Defining Carpal Tunnel Syndrome in Population-Based Research Studies

Details

• Personal Author:
  Coomes J ; Dale, Ann M. ; Descatha A ; Evanoff B ; Franzblau, Alfred ; Coomes J ; Dale, Ann M. ; Descatha A ; Evanoff B ; Franzblau, Alfred
• Description:
  OBJECTIVE: We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. METHODS: We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. RESULTS: The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was <50% for all strategies tested. CONCLUSION: Our study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings. [Description provided by NIOSH]
• Subjects:
  Environmental Monitoring Epidemiology Ergonomics Musculoskeletal Diseases Occupational Exposure Occupational Health Safety Surveys And Questionnaires Workplace
• Keywords:
  Exposure-assessment Exposure-levels Exposure-methods Injuries Injury-prevention Musculoskeletal-system-disorders Occupational-exposure Occupational-hazards Questionnaires Statistical-analysis Work-analysis Work-performance Work-practices Worker-health Workplace-studies

  More +
• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  Missouri ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  133-135
• Volume:
  67
• Issue:
  2
• NIOSHTIC Number:
  nn:20036709
• Citation:
  Occup Environ Med 2010 Feb; 67(2):133-135
• Contact Point Address:
  Dr Alexis Descatha, Unité de pathologie professionnelle, CHU Poincaré, 104 bd R. Poincaré, 92380 Garches, France
• Email:
  alexis.descatha@rpc.aphp.fr
• Federal Fiscal Year:
  2010
• NORA Priority Area:
  Construction ; Manufacturing ; Construction ; Manufacturing
• Performing Organization:
  Washington University - St. Louis, Missouri
• Peer Reviewed:
  True
• Start Date:
  20040601
• Source Full Name:
  Occupational and Environmental Medicine
• End Date:
  20151231
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5fee6c4c41712077f865c18fcfc3ef3731da5bfad7c38f2a9f994f82abdbd1a0fb8c60d54939be3451a0668f954827449faef903efd70ab6a8cf939ed9734be5
• Download URL:
  https://stacks.cdc.gov/view/cdc/188024/cdc_188024_DS1.pdf
• File Type:
  [PDF - 63.10 KB ]