Background: Carpal tunnel syndrome (CTS) is a very common disease (10% life-time risk of developing this pathology) and has a particular clinical-instrumental pattern: clinical diagnosis is usually easy and sensitive, so it is considered the gold standard test, but in most cases clinical diagnosis is only based on history and on referred symptoms while clinical examination is normal. On the other hand neurophysiological evaluation is a very sensitive diagnostic method (<95%) and it is now considered fundamental to confirm the clinical diagnosis. Methods: The "Italian CTS Study Group" has performed a wide multicentric study (20 centres) on 1123 idiopathic CTS hands through a large and multi-prospective evaluation. A thorough assessment was obtained through: 1) the patient-oriented measurement by a validated self-administered questionnaire (Boston Carpal Tunnel Questionnaire - using the validated Italian version); 2) the physician-oriented evaluation (an historical-objective scale was used); 3) the neuropysiological evaluation (according to the neurophysiological classification and following the American Association of Electrodiagnostic Medicine guidelines). Results and conclusion: New and interesting data were observed: male and female CTS differences, the different behaviours of symptoms and hand function in relation to the nerve impairment etc. Some of the results have confirmed some commonly-accepted data, conclusively assessing it with a well-represented population and using validated measurements. Moreover, such an amount of data disclosed new interesting relationships. The clinical-neurophysiological assessment, never performed before in such a wide population, appeared extremely consistent and especially the patient-oriented measurement of CTS provides interesting information. Vice versa, CTS appeared as an ideal model to evaluate the importance of different parameters for outcome assessment.
Carpal Tunnel Syndrome: An Ideal Model to Compare Patients, Psysician-and Neurophysiological Oriented Outcomes-Italian Multicenterric Study of CTS (1123 Hands)
ZANOLI, Gustavo Alberto;
1999
Abstract
Background: Carpal tunnel syndrome (CTS) is a very common disease (10% life-time risk of developing this pathology) and has a particular clinical-instrumental pattern: clinical diagnosis is usually easy and sensitive, so it is considered the gold standard test, but in most cases clinical diagnosis is only based on history and on referred symptoms while clinical examination is normal. On the other hand neurophysiological evaluation is a very sensitive diagnostic method (<95%) and it is now considered fundamental to confirm the clinical diagnosis. Methods: The "Italian CTS Study Group" has performed a wide multicentric study (20 centres) on 1123 idiopathic CTS hands through a large and multi-prospective evaluation. A thorough assessment was obtained through: 1) the patient-oriented measurement by a validated self-administered questionnaire (Boston Carpal Tunnel Questionnaire - using the validated Italian version); 2) the physician-oriented evaluation (an historical-objective scale was used); 3) the neuropysiological evaluation (according to the neurophysiological classification and following the American Association of Electrodiagnostic Medicine guidelines). Results and conclusion: New and interesting data were observed: male and female CTS differences, the different behaviours of symptoms and hand function in relation to the nerve impairment etc. Some of the results have confirmed some commonly-accepted data, conclusively assessing it with a well-represented population and using validated measurements. Moreover, such an amount of data disclosed new interesting relationships. The clinical-neurophysiological assessment, never performed before in such a wide population, appeared extremely consistent and especially the patient-oriented measurement of CTS provides interesting information. Vice versa, CTS appeared as an ideal model to evaluate the importance of different parameters for outcome assessment.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
