Thumbs up

Abstract

Purpose: Overuse syndromes, such as de Quervain's tenosynovitis of the left thumb, have been reported among high volume endoscopists. * Our purpose was to determine the incidence of overuse syndromes among endoscopists in Illinois, and to correlate overuse syndromes with volume of endoscopy and years in practice. Methods: A brief two-page survey was mailed to members of the American Gastroenterological Association in Illinois. The survey asked for age, years in practice, and number of endoscopies performed per year; the presence and severity of pain in the thumb, hand, wrists, elbow, shoulder, neck and back; and whether the respondents felt their pain was attributable to endoscopy. The injured group was analyzed to correlate injury with endoscopic volume and years in practice. Chi squared and Mann-Whitney U tests were used. Results: 476 surveys were mailed and 23 surveys were returned undeliverable, for a total of 453 surveys delivered. 157 responses were received (35%). Respondent characteristics: average age 47, 85% male, 93% right-handed. Years in practice of respondents: less than 10 years 29%, greater than 10 years 71%. Volume of endoscopies per year: zero 1%, 1 –500 19%, 501 –1000 22%, 1,001 –1,500 33%, > 1,500 25%. Fifty-six percent reported some pain during their endoscopic career whereas 44% experienced no pain. Seventy-three percent ranked their pain as either mild (42%) or moderate (31%), whereas 27% ranked their pain as severe. Overuse syndromes correlated significantly with endoscopic volume (P= 0.04). Of respondents who ranked their pain as severe, a greater percent were in practice for greater than 10 years (86%) compared to less than ten years (14%). There was a trend to greater severity of injury in those individuals performing greater than 1000 endoscopies per year. Conclusion: Overuse syndromes are not uncommon among endoscopists. Most overuse syndromes are mild or moderate, but occasionally can cause severe pain. Increasing volume of endoscopy increased both the risk and severity of overuse syndromes. Methods to reduce overuse syndromes among endoscopists would be of interest. *J Tsai, C Berkelhammer. “Thumbs Up: Endoscopist's Thumb as an Occupational Hazard of High Volume Endoscopy”. Am J Gastro 2007; 102: S2, 550 (Abstract).