D lagnosis Paresthesia感觉异常 over the sensory distribution of the median nerve is the most frequent symptom; it occurs more often in women and frequently causes the patient to awaken several hours after getting to sleep with burning and numbness of the hand that is relieved by exercise. The Tinel sign may be demonstrated in most patients by percussing?轻甲 the median nerve at the wrist. Atrophy to some degree of the median innervated thenar muscles has been reported in about half of the patients treated by operation
Diagnosis ◼ Paresthesia感觉异常 over the sensory distribution of the median nerve is the most frequent symptom; it occurs more often in women and frequently causes the patient to awaken several hours after getting to sleep with burning and numbness of the hand that is relieved by exercise. The Tinel sign may be demonstrated in most patients by percussing轻叩 the median nerve at the wrist. Atrophy to some degree of the medianinnervated thenar muscles has been reported in about half of the patients treated by operation
Acute flexion of the wrist for 60 seconds in some but not all patients or strenuous use of the hand increases he paresthesia. Application of a blood pressure cuff on the upper arm sufficient to produce venous distention may initiate the symptoms. Some studies evaluated the clinical usefulness of commonly administered provocative tests, including wrist flexion nerve percussion, and the tourniquet test, n 67 hands with electrical proof of carpal tunnel syndrome and in 50 control hands
◼ Acute flexion of the wrist for 60 seconds in some but not all patients or strenuous use of the hand increases the paresthesia. Application of a blood pressure cuff on the upper arm sufficient to produce venous distention may initiate the symptoms. Some studies evaluated the clinical usefulness of commonly administered provocative tests, including wrist flexion, nerve percussion, and the tourniquet test, in 67 hands with electrical proof of carpal tunnel syndrome and in 50 control hands
D lagnosis The most sensitive test was the wrist flexion test whereas nerve percussion was the most specific and the least sensitive. They also found that with the wrist in neutral position, the mean pressure within the carpal tunnel in patients with carpal tunnel syndrome was 32 mm Hg. This pressure increased to 99 mm Hg with 90 degrees of wrist flexion and to 110 mm hg with the wrist at 90 degrees of extenSion. The pressures in the control subjects with the wrist in neutral position were 25 mm hg, 3 1 mm hg with the wrist in flexion, and 30 mm Hg with the wrist in extension
Diagnosis ◼ The most sensitive test was the wrist flexion test, whereas nerve percussion was the most specific and the least sensitive. They also found that with the wrist in neutral position, the mean pressure within the carpal tunnel in patients with carpal tunnel syndrome was 32 mm Hg. This pressure increased to 99 mm Hg with 90 degrees of wrist flexion and to 110 mm Hg with the wrist at 90 degrees of extension. The pressures in the control subjects with the wrist in neutral position were 25 mm Hg, 31 mm Hg with the wrist in flexion, and 30 mm Hg with the wrist in extension
Sensibility testing in peripheral nerve compression syndromes was investigated, found that threshold tests of sensibility correlated accurately with symptoms of nerve compression and electrodiagnostic studies 掌腕韧带 正中神经 中
◼ Sensibility testing in peripheral nerve compression syndromes was investigated, found that threshold tests of sensibility correlated accurately with symptoms of nerve compression and electrodiagnostic studies
Electrodiagnostic电生理 studies are reliable confirmatory tests Ultrasonography超声检查 has been used to show the movement of the flexor tendons within the carpal tunnel, but it does not clearly show soft tissue planes. Early reports of magnetic resonance imaging MRI in carpal tunnel syndrome are promising. A major advantage of MrI is its high soft tissue contrast, which gives detailed images of both bones and soft tissues. Care should be taken not to confuse this syndrome with nerve compression caused by a cervical disc herniation, thoracic outlet structures, and median nerve compression proximally in the forearm and at the elbow
◼ Electrodiagnostic电生理 studies are reliable confirmatory tests. Ultrasonography超声检查 has been used to show the movement of the flexor tendons within the carpal tunnel, but it does not clearly show soft tissue planes. Early reports of magnetic resonance imaging (MRI) in carpal tunnel syndrome are promising. A major advantage of MRI is its high soft tissue contrast, which gives detailed images of both bones and soft tissues. Care should be taken not to confuse this syndrome with nerve compression caused by a cervical disc herniation, thoracic outlet structures, and median nerve compression proximally in the forearm and at the elbow