Purpose
Gradual onset diseases (eg, carpal tunnel syndrome, cubital tunnel syndrome, and trapeziometacarpal
arthrosis) tend to go unnoticed for years. When a slowly progressive disease transitions
from asymptomatic to symptomatic, it may seem like an acute event. The primary aim
of this study was to determine the percentage of patients who perceive the slowly
progressive disease as having started within 1 year. We also hypothesized that (1)
there would be no factors associated with perception of an onset of disease within
1 year, more specifically among patients with advanced disease; and (2) there would
be no difference in a decision to pursue operative treatment between patients who
perceived the onset of the disease to be recent and those who perceived it to be long-standing.
Methods
In this retrospective study, we reviewed the medical records of 732 patients newly
diagnosed with carpal tunnel syndrome (n = 114), cubital tunnel syndrome (n = 276),
or trapeziometacarpal arthrosis (n = 342), for the onset of symptoms. Multiple factors
were assessed for (1) association with perception of disease onset within 1 year,
and (2) choice for operative treatment in bivariate and multivariable analyses.
Results
A total of 69% of all subjects and 68% of patients with advanced disease perceived
the disease as having started within 1 year. A perceived provocation (such as an injury
or surgery) was associated with a perception of recent onset. A decision to pursue
operative treatment was not different between the 2 groups.
Conclusions
Slowly progressive diseases are often misperceived as relatively new.
Clinical relevance
Effective communication strategies are important to ensure that people make choices
consistent with their values and not based on misconceptions.
Key words
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Article info
Publication history
Published online: September 09, 2017
Accepted:
July 18,
2017
Received:
August 7,
2016
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
