Carpal Tunnel Syndrome
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Researchers from Case Western Reserve University publish findings in carpal tunnel syndrome
2009 JUL 13 - (NewsRx.com) -- "This clinical practice guideline was created to improve patient care by outlining the appropriate information-gathering and decision-making processes involved in managing the diagnosis of carpal tunnel syndrome. The methods used to develop this clinical practice guideline were designed to combat bias, enhance transparency, and promote reproducibility," scientists writing in the Journal of the American Academy of Orthopaedic Surgeons report. "The guideline's recommendations are as follows: The physician should obtain an accurate patient history. The physician should perform a physical examination of the patient that may include personal characteristics as well as performing a sensory examination, manual muscle testing of the upper extremity, and provocative and/or discriminatory tests for alternative diagnoses. The physician may obtain electrodiagnostic tests to differentiate among diagnoses. This may be done in the presence of thenar atrophy and/or persistent numbness. The physician should obtain electrodiagnostic tests when clinical and/or provocative tests are positive and surgical management is being considered. If the physician orders electrodiagnostic tests, the testing protocol should follow the American Academy of Neurology/American Association of Neuromuscular and Electrodiagnostic Medicine/American Academy of Physical Medicine and Rehabilitation guidelines for diagnosis of carpal tunnel syndrome. In addition, the physician should not routinely evaluate patients suspected of having carpal tunnel syndrome with new technology, such as magnetic resonance imaging, computed tomography, and pressure-specified sensorimotor devices in the wrist and hand," wrote M.W. Keith and colleagues, Case Western Reserve University. The researchers concluded: "This decision was based on an additional nonsystematic literature review following the face-to-face meeting of the work group.." Keith and colleagues published their study in the Journal of the American Academy of Orthopaedic Surgeons (Diagnosis of Carpal Tunnel Syndrome. Journal of the American Academy of Orthopaedic Surgeons, 2009;17(6):389-396). Additional information can be obtained by contacting M.W. Keith, Case Western Reserve University, Metrohlth Med Center, Hand Surgery Service, Cleveland, OH 44106, USA. The publisher of the Journal of the American Academy of Orthopaedic Surgeons can be contacted at: American Acad Orthopaedic Surgeons, 6300 N River Road, Rosement, IL 60018-4262, USA. Keywords: United States, Cleveland, Carpal Tunnel Syndrome, Neurology, Orthopedics, Case Western Reserve University. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.
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