Comparison of clinical tests versus electrodiagnostic testing in the diagnosis of pregnancy-related carpel tunnel syndrome

Abstract

Background: Pregnancy-related carpal tunnel syndrome (PRCTS) is a persistent mononeuropathy in pregnancy. The incidence of PRCTS has a wide fluctuation range of 0.8% to 70%. Their incidence depends on the diagnostic technique. The nerve conduction study (NCS) is a very specific test for the diagnosis of PRCTS. There have been very few studies to compare the results of diagnosing PRCTS via NCS with clinical tests. Aims and Objectives: To assess the most reliable technique in the diagnosis of PRCTS by comparing clinical tests with the nerve conduction studies in electrodiagnostic (EDX) testing. Materials and Methods: As per inclusion and exclusion criteria, 100 subjects were included in the study. Out of 75 pregnant females, 25 were agematched non-pregnant females as controls. All were enrolled in the ANC clinic and gynecology outpatient department of Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh. All the females were assessed for CTS by the clinical tests as well as the EDX test performed in the department of physiology at JNMCH and AMU. The testing was done at the wrist joint in order to assess the normal functioning of the median nerve. Results: There was a highly significant difference between the two methods for the diagnosis of PRCTS. Out of the total 75 pregnant females enrolled, only 2 were found to be positive for PRCTS via clinical testing, whereas in the EDX techniques, 48% of the pregnant females were diagnosed as having PRCTS. Conclusion: Clinical tests are not emerging as a good method for PRCTS diagnosis, while EDX testing is the gold standard and a prudent method to diagnose PRCTS.