COMPARISON BETWEEN A QUANTITATIVE CLINICAL SCALE AND NEUROPHYSIOLOGICAL EVALUATION IN CARPAL TUNNEL SYNDROME

Abstract

Background: Carpal Tunnel Syndrome (CTS) is one of the most frequent cause of pain and paresthesias in the upper extremities. Neurophysiological studies allow to confirm diagnosis based on clinical evaluation.Aim of the study: to investigate if the score of the Simovic and Weinberg Clinical Scale (SWCS) for CTS correlates to the neurophysiological severity assessment proposed by Padua.Material and methods: 65 consecutive patients with suspected CTS were examinated. 54 were females (mean age, 54.5; range, 23–83). Body mass index (BMI), wrist circumference, and symptoms duration were also calculated for each patient. The SWCS was administered to all patients before neurophysiological evaluation. The scale consists of 11 items (8 anamnestic and 3 clinical), which have a different impact on the total score (maximum 30/30). Diagnosis of CTS using SWCS can be probable (9–30/30), possible (7–8/30), or unlikely (1–6/30). CTS were classified using neurophysiological criteria according to Padua into six severity groups (from negative to extreme).Results: CTS severity according to Padua's criteria was related to higher scores in SWCS. No correlation was found comparing BMI and symptoms duration with clinical and neurophysiological severity. Wrist circumference was also not significant. There was no diagnosis of unlikely‐CTS at SWCS, but on the contrary 15 patients with probable CTS had no pathological findings at electrophysiological evaluation.Comment: Clinical severity assessed using SWCS correlates with neurophysiological severity. Irritative symptoms are easily recognized by the SWCS, even if there is no neurophysiological correlate. The use of a sensitive scale as SWCS allows to avoid useless neurophysiological studies if the diagnosis of CTS is unlikely.