1. Ranking of routine parameters for CTS
The 7-14 method
Ranking of routine parameters for CTS
Gunilla Ahlsén, Susanna Åkerlund, Erik Stålberg
Background: To find optimal parameters for the diagnosis of
Median nerve entrapment at the CT level. Accepted by ethics committe
Ter is
Method; 159 concecutive patients fulfilled inclusion criteria;
interpreted as CTS, bilateral or rightsided. Only right side studied.
All patients underwent tests with all parameters under study
Patients with concomittant diagnosis were included (pnp, root)
Exclusion criteria: CT operated
Results
The outcome of studies is seen in patients with CTS
%abn findings in CTS cases Slight - Severe
% abn findings in CTS cases slight-moderate
Normal median CV to dig IV
Normal med-uln CV diff dig IV
Following 4 plots of the entire material
pure motor
Med sens CV wrist-dig IV (SD)
Sens CV side diff uln-med IV
Sens CV side diff uln-med IV
pure sensory
M-lat med
Trans CT latency
Trans CT latency
Strategies in the evaluation of CTS
Conclusion for slight and moderate CTS
Transcarpal testing, the theoretically most logical test, is by far most sensitive EDX test
There are barely any false positive. 6/78 (not shown here). A bordeline value may be
verified by one more test.
Distal segment is often abnormal (we use 1.8 msec, others 2.2, msec).
Motor abnormalities seen in 55%. When med-ulff to IV is normal, Mlat may be
abnormal but not transCT
Abnormal med-uln diff to IV is diagnostic. No false positives
TransCT testing unique for CT slowing. Uln nerve abnormality not disturbing.
17% have no responses across the ligament (severe CT).
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