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

Authors
Dale-AM; Descatha-A; Coomes-J; Franzblau-A; Evanoff-B
Source
Am J Ind Med 2011 Jan; 54(1):1-9
NIOSHTIC No.
20038144
Abstract
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.
Keywords
Carpal-tunnel-syndrome; Exposure-assessment; Musculoskeletal-system-disorders; Nerves; Nervous-system; Neurological-system; Neuromuscular-system; Neurophysiological-effects; Physical-examination; Physiological-factors; Physiological-testing; Physiology; Preemployment-examinations; Questionnaires; Risk-analysis; Risk-factors; Statistical-analysis; Work-analysis; Work-environment; Work-operations; Work-performance; Work-performance; Workplace-studies; Author Keywords: carpal tunnel syndrome; post-offer pre-placement examinations; physical examination; screening; clinical epidemiology
Contact
Ann Marie Dale PhD, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri 63110
CODEN
AJIMD8
Publication Date
20110101
Document Type
Journal Article
Email Address
adale@dom.wustl.edu
Funding Type
Grant
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008017
Issue of Publication
1
ISSN
0271-3586
Priority Area
Services; Wholesale and Retail Trade
Source Name
American Journal of Industrial Medicine
State
MI; MO
Performing Organization
Washington University - St. Louis, Missouri
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