A THREE-ITEM QUESTIONAIRE SCREENING FOR THE CARPAL TUNNEL SYNDROME

Background Carpal tunnel syndrome (CTS) is the most common mononeuropathy. Electrodiagnostic testing improves outcome of patients with CTS. However, before referral to electrodiagnostic testing a simple screening test would be very useful. The aim of the study was to develop simple screening questionnaire for patients with suspected CTS. Methods Nerve conduction studies (median terminal motor latencies - 8 cm, antidromic sensory median and ulnar nerve conduction times to the ring finger - 14 cm) were performed in 100 consecutive patients referred to our electrodiagnostic unit due to suspected CTS. In addition, in all patients a 7 item screening questionnaire was applied. We tried to identify questions that indicate all patients with neurophysiologic abnormalities typical for CTS. Results At least 2 affirmative responses to 3 questions (tingling in at least two of the first four fingers; symptoms worse during the night/on awakening; improvement of symptoms on hand shaking) identified 97% of patients with characteristic electrodiagnostic abnormalities (p < 0.001). Conclusions A 3-item questionnaire enabled us to identify almost all patients with electrodiagnostic abnormalities typical for CTS. Electrodiagnostic studies serve then to exclude patients with false positive questionnaire result. In patients with suspected CTS we recommend use of our questionnaire, evaluation of thenar atrophy, and assessment of sensation in the first 3 1/2 fingers.