Physical examination has a low yield in screening for carpal tunnel syndrome

Details

• Personal Author:
  Coomes J ; Dale, Ann M. ; Descatha A ; Evanoff B ; Franzblau, Alfred
• Description:
  BACKGROUND: physical examination is often used to screen workers for carpal tunnel syndrome (CTS). In a population of newly hired workers, we evaluated the yield of such screening. METHODS: our study population included 1,108 newly hired workers in diverse industries. Baseline data included a symptom questionnaire, physical exam, and bilateral nerve conduction testing of the median and ulnar nerves; individual results were not shared with the employer. We tested three outcomes: symptoms of CTS, abnormal median nerve conduction, and a case definition of CTS that required both symptoms and median neuropathy. RESULTS: of the exam measures used, only Semmes-Weinstein sensory testing had a sensitivity value above 31%. Positive predictive values were low, and likelihood ratios were all under 5.0 for positive testing and over 0.2 for negative testing. CONCLUSION: physical examination maneuvers have a low yield for the diagnosis of CTS in workplace surveillance programs and in post-offer, pre-placement screening programs. [Description provided by NIOSH]
• Subjects:
  Environmental Monitoring Musculoskeletal Diseases Musculoskeletal System Nervous System Occupational Health Risk Assessment Risk Factors Safety Surveys And Questionnaires Workplace
• Keywords:
  Author Keywords: Carpal Tunnel Syndrome Carpal-tunnel-syndrome Clinical Epidemiology Exposure-assessment Musculoskeletal-system-disorders Nerves Nervous-system Neurological-system Neuromuscular-system Neurophysiological-effects Physical-examination Physical Examination Physiological-factors Physiological-testing Physiology Post-offer Pre-placement Examinations Preemployment-examinations Questionnaires Risk-analysis Risk-factors Screening Statistical-analysis Work-analysis Work-environment Work-operations Work-performance Workplace-studies

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; Missouri ; OSHA Region 5 ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-9
• Volume:
  54
• Issue:
  1
• NIOSHTIC Number:
  nn:20038144
• Citation:
  Am J Ind Med 2011 Jan; 54(1):1-9
• Contact Point Address:
  Ann Marie Dale PhD, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri 63110
• Email:
  adale@dom.wustl.edu
• Federal Fiscal Year:
  2011
• NORA Priority Area:
  Construction ; Manufacturing
• Performing Organization:
  Washington University - St. Louis, Missouri
• Peer Reviewed:
  True
• Start Date:
  20040601
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20151231
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8d6a1a5106aba0313a1a4fe971953cbae2af018228756a96767b9bfc86ff8a84c7c173ca4cf34a841715edb371230c75481a3ab9f607a4a6c8c8d13c2e832ae0
• Download URL:
  https://stacks.cdc.gov/view/cdc/191942/cdc_191942_DS1.pdf
• File Type:
  [PDF - 196.81 KB ]