Purpose
Although carpal tunnel syndrome (CTS) can be diagnosed clinically with the Carpal
Tunnel Syndrome 6 (CTS-6) evaluation tool, the relationship between disease severity
and CTS-6 score has not been elucidated. The purpose of our study was to determine
the correlation of the CTS-6 score and other physical examination maneuvers with the
carpal tunnel severity grade by electrodiagnostic testing (EDT). We hypothesized that
the CTS-6 score, Durkan test, and Semmes Weinstein Monofilament Testing (SWMT) positively
correlate with EDT severity.
Methods
We prospectively enrolled 105 consecutive patients who presented to the office with
suspected CTS, excluding those with previous surgery, previous EDT from an outside
facility, or concomitant neuropathy. Four fellowship-trained hand surgeons obtained
the CTS-6 score, time to obtain a positive Durkan compression test, and SWMT of the
thumb, index, and middle fingers. All patients were sent for EDT. Hand surgeons were
blinded to the results of the EDT, and the electrodiagnosticians were blinded to the
clinical data. We used the Bland criteria (0–6) to grade CTS severity on EDT. This
grade was compared with the CTS-6 score, Durkan time, and SWMT results.
Results
Using Spearman correlation coefficients, we found a weakly positive correlation between
a higher CTS-6 score and a higher severity grade on EDT. The mean CTS-6 score based
on EDT grading were the following: (1) 14.8 (grade 0), (2) 16.0 (grade 1), (3) 14.8
(grade 2), (4) 16.7 (grade 3), (5) 18.7 (grade 4), (6) 18.3 (grade 5), and (7) 22.4
(grade 6). We also found a statistically significant association between the SWMT
and a higher CTS-6 score as well as a higher severity grade on EDT. Durkan compression
test did not appear to correlate with the EDT grade.
Conclusions
The CTS-6 and SWMT show a positive correlation with EDT severity in CTS on the basis
of the Bland criteria. The time to a positive Durkan test did not show any correlation.
Type of study/level of evidence/Level of Evidence
Diagnostic II.
Key words
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Article info
Publication history
Published online: February 05, 2023
Accepted:
November 18,
2022
Received:
November 3,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
