What Is Carpal Tunnel Syndrome?

Article Abstract:

The relationship between symptoms of carpal tunnel syndrome (CTS) and nerve disease in the wrist is weak. CTS is an overuse injury that causes pain, tingling, and numbness in the wrist and hands. Physicians typically rely on a patient's medical history, physical examination, and nerve conduction tests to diagnose CTS. However, most patients with symptoms of CTS do not have nerve disease, and most patients with median nerve disease do not have symptoms of CTS. Reliance on patient history and clinical examination alone are insufficient to accurately determine which patients may benefit from carpal tunnel release surgery. Physicians need to better understand the physiology of CTS.

United States, Editorial, Statistical Data Included, Neural conduction

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Does This Patient Have Carpal Tunnel Syndrome?

Article Abstract:

Many of the physical signs that doctors use to diagnose carpal tunnel syndrome are not accurate. This was the conclusion of researchers who analyzed 12 medical reports that compared traditionally used physical signs with the results of nerve conduction studies. The physical signs that were most strongly linked to a positive result on nerve conduction studies included a greater than normal response to pain in the median nerve, weakness in moving the thumb, and specific hand symptoms noted by the patient on a Katz hand diagram. Phalen and Tinel signs, thenar atrophy, and vibratory and monofilament sensory testing were of little value.

Methods, Physical diagnosis, Medical examination

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Is This Patient Hypovolemic?

Article Abstract:

The most accurate physical findings in patients with hypovolemia are dizziness and a large increase in the heart rate when the patient stands up after lying down. Hypovolemia occurs when a person loses large amounts of fluid. This can occur after prolonged vomiting, blood loss, or dehydration. Researchers analyzed 10 studies that investigated the accuracy of several physical findings in diagnosing hypovolemia. The most accurate findings were dizziness and an increase in heart rate of 30 beats per minute or more when the patient lies down and then stands up. These findings were most accurate in diagnosing severe fluid loss.

Dehydration (Physiology)

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