Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan;14(1):56-58.
doi: 10.1177/1558944718798849. Epub 2018 Sep 6.

Utilization of Electrodiagnostic Testing for Carpal Tunnel Syndrome by General Practitioners Prior to Hand Surgery Consultation

Affiliations

Utilization of Electrodiagnostic Testing for Carpal Tunnel Syndrome by General Practitioners Prior to Hand Surgery Consultation

Joshua Colombo et al. Hand (N Y). 2019 Jan.

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common peripheral mononeuropathy and thus is frequently encountered by general practitioners (GPs). The aim of this study is to investigate the referral pattern of GPs with regard to electrodiagnostic (EDX) testing for suspected CTS prior to hand surgery consultation, as well as to investigate the results of EDX testing for suspected CTS when requested by GPs prior to evaluation by a hand surgeon.

Methods: We retrospectively reviewed patients referred to our hand surgery clinic over a consecutive 2-year period for suspected CTS.

Results: A total of 403 patients were referred to our hand surgery clinic from January 1, 2016, to December 31, 2017. Of the 403, 295 (73.2%) were referred by GPs. GPs obtained prereferral EDX testing in 198 (67.1%) of these patients. EDX testing confirmed their diagnosis in 177 patients (89.4%). There were 21 patients (10.6%) identified with normal EDX testing and a more likely diagnosis reached based on clinical examination.

Conclusions: GPs make up the majority of our referrals for CTS, and they obtain EDX testing prior to consultation in two-thirds of referrals. GPs appear to accurately utilize EDX testing to confirm their diagnosis prior to referral and have a low rate of normal testing where symptoms are more readily explained by an alternative diagnosis.

Keywords: carpal tunnel syndrome; electrodiagnostic testing; general practitioners; referrals; utilization.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Comment in

References

    1. Bongers FJ, Schellevis FG, Van den bosch WJ, et al. Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors. Br J Gen Pract. 2007;57(534):36-39. - PMC - PubMed
    1. Schappert SM. National Ambulatory Medical Care Survey: 1990 summary. Adv Data. 1992(213):1-11. - PubMed
    1. Phalen GS. The carpal-tunnel syndrome: clinical evaluation of 598 hands. Clin Orthop Relat Res. 1972;83:29-40. - PubMed
    1. Gellman H, Gelberman RH, Tan AM, et al. Carpal tunnel syndrome. An evaluation of the provocative diagnostic tests. J Bone Joint Surg Am. 1986;68(5):735-737. - PubMed
    1. Katz JN, Larson MG, Sabra A, et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Intern Med. 1990;112(5):321-327. - PubMed