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Journal of the Korean Academy of Rehabilitation Medicine 2003;27(3):361-368.
Correlation of Clinical Symptoms and Physical Signs with Electrodiagnostic Findings in Carpal Tunnel Syndrome.
Hyun, Jung Keun , Lee, Seong Jae , Kwon, Ho Jang , Ha, Mina , Lee, Jongmin , Kwon, Jeong Yi , Kim, Joon Sung , Paik, Nam Jong , Lee, Ho , Kwon, Bum Sun
1Department of Rehabilitation Medicine , Dankook University, Korea. rhhyun@dankook.ac.kr
2Department of Preventive Medicine, Dankook University, Korea.
3Department of Rehabilitation Medicine, Dongguk University, Korea.
4Department of Rehabilitation Medicine, The Catholic University of Korea.
5Department of Rehabilitation Medicine, Seoul National University, Korea.
6Department of Rehabilitation Medicine, Soonchunhyang University, Korea.
수근관 증후군의 임상 증상 및 이학적 소견과 전기진단 소견과의 연관성
현정근, 이성재, 권호장1, 하미나1, 이종민2, 권정이3, 김준성3, 백남종4, 이호5, 권범선
단국대학교 의과대학 재활의학교실 및 1예방의학교실, 2동국대학교 의과대학 재활의학교실, 3가톨릭대학교 의과대학 재활의학교실, 4서울대학교 의과대학 재활의학교실, 5순천향대학교 의과대학 재활의학교실
Abstract
Objective
This study was to evaluate the correlation of clinical symptoms and physical signs with electrodiagnostic findings in carpal tunnel syndrome (CTS), and to increase the usefulness of clinical symptoms and physical signs in the diagnosis of CTS.


Method
We prospectively identified 322 hands from 172 subjects clinically from 5 tertiary hospitals. All subjects completed 6 clinical symptoms and 6 physical signs including 3 provocative tests. Each symptoms and signs were divided motor and sensory symptoms and signs, and the correlation between symptoms and signs and the results of motor and sensory conduction studies and needle electromyography were evaluated. The sensitivity and specificity of each valuable symptoms and signs for electrodiagnostic results were also assessed.


Results
Tingling sensation, nocturnal pain, worsening, and Phalen sign were correlated with motor conduction study, and falling tendency, abductor pollicis brevis weakness and atrophy, tingling sensation, hypoesthesia, and Tinel and Phalen signs were correlated with needle electromyography. The Phalen sign had the best sensitivity and specificity for median motor conduction study, and the best sensitive physical sign for needle electromyography.


Conclusion
Motor and sensory symptoms and signs were not correlated with motor and sensory conduction studies, but motor symptoms and signs were correlated with needle electromyography. The Phalen test was the most useful evaluating tool to diagnose CTS. (J Korean Acad Rehab Med 2003; 27: 361-368)

Key Words: Carpal tunnel syndrome, Electrodiagnosis, Clinical symptom, Physical sign


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