Hand Diagram Research Articles

Ulnar Neuropathy Among Active Workers Based Upon Hand Diagram Ratings

BackgroundLimited studies have estimated the prevalence of ulnar neuropathy (UN) in the workplace. Hand diagrams have been demonstrated to have a good sensitivity and specificity when attempting to identify patients with UN. ObjectiveTo determine the prevalence and associated risk factors for UN among active workers based on results of a hand diagram, and to determine the reliability of hand diagram scoring. DesignCross-sectional study. SettingSeven different industrial and clerical work sites. MethodsA total of 501 active workers were screened. Subjects completed a hand diagram and the Job Content Questionnaire, and had ergonomic assessment of their job. Each hand diagram was scored independently by 2 raters. Main Outcome MeasuresRating of the hand diagram for UN. ResultsInterrater reliability of scoring the hand diagram for UN was very high. The estimated prevalence of UN was 3.6%. Suspected UN was associated with positioning of the elbow but not by contact stress at the elbow or force at the hand. Smokers had a lower prevalence, but smokers with suspected UN had higher-pack year histories. Workers with suspected UN had a greater sense of job insecurity and lower job satisfaction rating. ConclusionsHand diagram rating has a high interrater reliability. Suspected UN has a relatively high prevalence among active workers in comparison to prior estimates of the prevalence of UN among the general population and is not strongly associated with ergonomic factors.

Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome

BackgroundTo inform the clinical management of patients with suspected carpal tunnel syndrome (CTS) and case definition for CTS in epidemiological research, we explored the relation of symptoms and signs to sensory nerve conduction (SNC) measurements.MethodsPatients aged 20–64 years who were referred to a neurophysiology service for investigation of suspected CTS, completed a symptom questionnaire (including hand diagrams) and physical examination (including Tinel’s and Phalen’s tests). Differences in SNC velocity between the little and index finger were compared according to the anatomical distribution of symptoms in the hand and findings on physical examination.ResultsAnalysis was based on 1806 hands in 908 patients (response rate 73%). In hands with numbness or tingling but negative on both Tinel’s and Phalen’s tests, the mean difference in SNC velocities was no higher than in hands with no numbness or tingling. The largest differences in SNC velocities occurred in hands with extensive numbness or tingling in the median nerve sensory distribution and both Tinel’s and Phalen’s tests positive (mean 13.8, 95% confidence interval (CI) 12.6-15.0 m/s). Hand pain and thumb weakness were unrelated to SNC velocity.ConclusionsOur findings suggest that in the absence of other objective evidence of median nerve dysfunction, there is little value in referring patients of working age with suspected CTS for nerve conduction studies if they are negative on both Tinel’s and Phalen’s tests. Alternative case definitions for CTS in epidemiological research are proposed according to the extent of diagnostic information available and the relative importance of sensitivity and specificity.

Ultrasound for carpal tunnel syndrome screening in manual laborers

Manual laborers are at increased risk for carpal tunnel syndrome (CTS), and a combination of history, physical examination, and nerve conduction studies is often used to screen for CTS in this population. Neuromuscular ultrasound may be a better screening tool, because it is painless. In this study we compare the accuracy of nerve conduction studies and ultrasound for CTS screening. Five hundred thirteen manual laborers were screened prospectively for CTS using nerve conduction studies and neuromuscular ultrasound, and the accuracy of the 2 techniques was compared using the Katz hand diagram as the diagnostic standard. The ROC curves for the 2 techniques were not significantly different (P = 0.542), indicating that the approaches had similar diagnostic accuracy. Neuromuscular ultrasound is a painless technique that has diagnostic accuracy similar to nerve conduction studies and can be used to screen large populations at risk for CTS.

Simple clinical tests in severe carpal tunnel syndrome.

Patients with severe carpal tunnel syndrome may be characterised by an atypical clinical picture. They assess complaints as becoming less bothersome than in the past. It seems that this may influence the diagnostic value of some clinical tests used in physical examinations. The aim of the study was the selection of the most reliable clinical tests in a group of patients with severe carpal tunnel syndrome. The material comprised 38 cases of severe form of the disease in a group of 37 prospective patients. The methods consisted in the evaluation of the rate of positive results of selected clinical tests, and in the comparison of their statistical correlation with selected parameters of median nerve conduction. The study results indicated that high incidence of two-point discrimination disorders showed a correlation with the sensory conduction parameters, including the median-ulnar sensory latency difference. The Durkan's and Phalen's tests were positive in almost all patients with advanced carpal tunnel. The Katz hand diagram revealed significantly enhanced sensitivity in the "probable" pattern. We speculate that the two-point discrimination, evaluated with the use of a simple paper clip, enables the selection of a group of patients with severe form of the syndrome for further differentiation. The tool used for facilitating the differential diagnosis is the Katz hand diagram. The Durkan's and Phalen's tests have an equally high value. However, they show no correlation with the conduction parameters, as measured by EMG.

Use of hand diagrams in screening for ulnar neuropathy: Comparison with electrodiagnostic studies

The objective of this study was to determine whether a hand diagram could be used to predict ulnar mononeuropathy. This was a prospective study of 117 consecutive patients referred for hand symptoms. Each subject filled out a hand diagram of symptoms and had median and ulnar sensory and motor nerve conduction studies, including ulnar conduction across the elbow. The best model for predicting an ulnar mononeuropathy included hand diagram scores of definite or possible. The model had a sensitivity of 50% and specificity of 93% with an ROC area of 0.90. The ulnar hand diagram scoring system can be useful as a screening tool in the electrodiagnostic laboratory or for epidemiologic studies.

Sonographically Guided Percutaneous Needle Release of the Carpal Tunnel for Treatment of Carpal Tunnel Syndrome

The purpose of this study was to evaluate the effectiveness of a novel treatment procedure, sonographically guided percutaneous needle release of the carpal tunnel, for individuals with carpal tunnel syndrome. Seventeen patients (89% female; mean age, 62 years; SD, 13.6 years) with a clinical diagnosis of carpal tunnel syndrome who had undergone a sonographically guided percutaneous needle release of the carpal tunnel at least 6 months before follow-up evaluation were retrospectively reviewed. At the follow-up evaluation, to ascertain previous and current symptoms as well as functional impairment, the patients filled out a hand diagram and a questionnaire. In addition, medical records were reviewed, and patients were queried regarding complications such as infection or nerve damage. Median nerve sonographic measurements and a physical evaluation were performed on a subset of 13 patients who came to the office for evaluation. Postprocedure sonography showed that patients had a significantly smaller (P = .03) cross-sectional area of the median nerve compared to pretreatment values. In addition, patients had significantly fewer symptoms (P < .0001), less functional impairment (P = .0002), and an improved hand diagram score (P < .0001). Postprocedure patients had grip strength that was 12 lb below average (≈1 SD below) compared to grip strength norms. However, most patients (84.6%) had negative clinical diagnostic test results for carpal tunnel syndrome, and 86% said they were satisfied with the procedure. There were no procedure-related infections or nerve injuries. Of the patients with carpal tunnel syndrome who agreed to participate in this study, most had favorable symptomatic and functional outcomes. Sonographically guided percutaneous needle release of the carpal tunnel may be an alternative option to traditional surgical treatment of carpal tunnel syndrome.

PA01.49.Carpal tunnel syndrome: A case report

Purpose: Carpal tunnel syndrome is an entrapment neuropathy of median nerve causing paraesthesia, pain, numbness and other symptoms in the distribution of median nerve due to its compression at wrist in carpal tunnel. Modern medicine prescribes surgery for its treatment. We report a case that was treated completely without any recurrence. Method: Case presentation: A female patient aged 23 years presented with numbness in the middle finger of left hand associated with paraesthesia, morning stiffness, loss of delicate movements of middle finger and dropping of small objects since 4 days. She consulted an allopathic doctor and was diagnosed as having Carpal tunnel syndrome (CTS). She was advised surgery. The patient was reluctant for undergoing surgery and took the medicines for 1 day, but had no relief. Next day she came to the OPD. On examination, Tinel™s percussion test and hand diagram were positive. On assessment, symptom severity scale (SSS) and functional status scale (FSS) were found to be 1.5 and 3.5 respectively, before treatment. Treatment given was varanadi kashaya, sahacharadi and supti taila, yogaraja guggulu, cap chelnar, dhanyamla dhara, shunthibaladi choorna etc, for a period of 1 month. The medicines were changed as per the condition of patient and the disease, at every follow up of 1 week, during the 1 month of treatment. Result: At the end of 1 month patient got complete relief from her complaints, and the scales SSS and FSS scored 0. Conclusion: The treatment given here aimed at release of compression by considering the involvement of doshas. The state of the disease was acute due to which complete relief was achieved. Thus if patients come to Ayurveda in early stages of the disease, prognosis will be better.

Carpal Tunnel Syndrome: The Role of Occupational Factors Among 906 Workers

BackgroundCarpal tunnel syndrome (CTS) is common in the industrial setting. However,there is a controversy about the sole role of occupational ergonomic hazards in CTS.ObjectivesThis study was conducted among assembling workers of a detergent factory and computer users with the aims of A) determination of CTS prevalence and B) evaluation of personal risk factors and level of exposure to occupational risk factors via Quick Exposure Check (QEC).Materials and MethodsIn this descriptive cross-sectional study, 906 cases (332 assembling workers and 574 computer workers) were enrolled. CTS was assessed by symptoms on the Katz hand diagram and physical examination. QEC technique was applied to evaluate physical exposure to the risk factors.ResultsAccording to this study, the prevalence of probable CTS was 14% in men and 8.9% in women; the rate of probable CTS was significantly higher in assembly workers than in computer users (P < 0.001). Mean age and work duration in the probable CTS group was statistically higher than in non-CTS group. But both groups were in the same range (fewer than 30, P = 0.024, 0.004); BMI in the probable CTS group was slightly lower than in non CTS group, but BMI in both groups were in the normal range. Wrist ratio > 0.7 correlated with increased risk of probable CTS (P < 0.001) Prevalence of probable CTS was significantly higher in third and fourth levels of QEC (P < 0.001).ConclusionsAlthough this article had limitations, our findings suggest that the level of occupational exposure is an indicator of CTS development.

Characteristics of Sleep Disturbance in Patients with Carpal Tunnel Syndrome

Sleep disturbance is common in carpal tunnel syndrome (CTS), and we hypothesize that it has an important impact on the quality of life of CTS patients. The characteristic of sleep problems associated with CTS has not been evaluated. We performed a case-control study to measure the association between a variety of sleep disturbances and CTS. Sixty-two cases with clinically diagnosed CTS and a probable or classic hand diagram were compared to 138 primary care patients without CTS. In addition to demographic features, we collected the nature of sleep disturbance experienced by the patients from a categorical list and the nature, impact, and severity of sleep disturbance using the Insomnia Severity Index. Patients with CTS complained of significantly more severe problems with sleep than the control population and had multiple sleep complaints compared to the control group. Sixty-three of the 138 control patients indicated that they had one cause of sleeping disturbance with no control patient choosing more than one. In contrast, in CTS patients, 44 of 63 patients indicated they had two or more causes of sleep disturbance. The Insomnia Severity Index was significantly higher in CTS patients and the impact of sleep disturbance on quality of life was higher in the cases. Sleep disturbance in CTS patients is characterized by a broad array of physical symptoms that have a significant impact on quality of life.

Performance of Simplified Scoring Systems for Hand Diagrams in Carpal Tunnel Syndrome Screening

Katz et al have published a standardized scoring system of hand diagrams for carpal tunnel syndrome. The purpose of this study was to quantitatively evaluate an alternative scoring of the hand diagram for detection of carpal tunnel syndrome. In a prospective study of 1,107 workers, 221 workers with hand symptoms completed hand diagrams and electrodiagnostic testing for carpal tunnel syndrome. Scoring algorithms for the hand diagrams included the Katz rating; a median nerve digit score (0-2) with a maximum of 2 symptomatic digits of thumb, index, and long fingers; and isolated digit scores (0-1) of thumb, index, or long finger. Intraclass correlation coefficients quantified inter-rater reliability. Sensitivity, specificity, and logistic regression analyses evaluated the scoring systems' ability to predict abnormal median nerve conduction. One hundred ten subjects illustrated symptoms within the median nerve distribution. All scoring systems demonstrated substantial inter-rater reliability. "Classic" or "probable" Katz scores, median nerve digit score of 2, and positive long finger scores were significantly associated with abnormal median nerve distal sensory latency and median-ulnar difference. Abnormal distal motor latency was significantly associated with the median nerve digit score of 2 and positive long finger scores. Increasing Katz scores from "possible" to "probable" and "classic" were not associated with greater odds of electrodiagnostic abnormality. Positive long finger scores performed at least as well as the most rigorous scoring by Katz. Symptoms diagrammed within the median nerve distribution are associated with abnormal nerve conduction among workers. The median nerve digit score and the long finger score offer increased ease of use compared to the Katz method, while maintaining similar performance characteristics. The long finger appears best suited for isolated digit scoring to predict abnormal median nerve conduction in a working population. Diagnostic II.

Workplace and individual risk factors for carpal tunnel syndrome

ObjectivesTo quantify the relationship between workplace physical factors, particularly hand activity level (HAL) and forceful exertion and carpal tunnel syndrome (CTS), while taking into account individual factors. To compare quantitative...

Sonographic assessment of carpal tunnel syndrome in rheumatoid arthritis: prevalence and correlation with disease activity

Carpal tunnel syndrome (CTS) is one of the most frequent extra-articular manifestations of rheumatoid arthritis (RA). High frequency ultrasonography (US) is a sensitive and specific method in diagnosis of CTS. This study is aimed to: firstly assess diameter frequency of CTS in RA with US and compare with a control group; secondly, investigate relationship of CTS with disease activity. One hundred consecutive RA patients (women/men: 78/22) fulfilling ACR 1987 RA criteria and 45 healthy controls (women/control: 34/11) were enrolled into study. Disease activity parameters, RA and CTS patient global assessment and health assessment questionnaire (HAQ-DI) were recorded. Both patient and control group were questioned about secondary causes of CTS, and Katz hand diagram, Boston CTS questionnaire and Phalen ve Tinel tests were applied once for each hand. Wrist joint and carpal tunnel were assessed with US grey scale and power Doppler US, then cross-sectional area of median nerve (CSA) was calculated. Patients with median nerve CSA between 10.0 and 13.0 mm(2) were evaluated with electromyography (EMG). CTS was diagnosed if CSA of median nerve >13.0 mm(2) or CTS was shown with NCS. Although there was no difference between RA patients and controls in age, sex, history of DM (+) and goitre, CTS was more frequent in RA group (respectively, 17.0% vs. 4.4%, P = 0.038). In RA group with CTS, age, history of DM, disease duration, HAQ-DI score, CTS patient global score, Boston symptom severity and functional status scores were elevated compared to without CTS [respectively, 57 (36-73) vs. 50 (24-76), P = 0.041; 35.3% vs. 6.0%, P < 0.001; 108 (12-396) months vs. 72 (6-360) months, P = 0.036; 1.93 (0.75-2.87) vs. 1.125 (0-2.75), P = 0.013; 52 (1-97) vs. 25 (0-91), P = 0.001; 2.81 (1.18-4.17) vs. 2.0 (1.0-4.01), P = 0.01; 3.37 (1.37-5.0) vs. 2.25 (1.0-5.0), P = 0.008]. No difference was found between CTS (+) and (-) RA patients in acute phase reactants, disease activity and US findings (P > 0.05). Sensitivity of Katz hand diagram was higher than Tinel and Phalen tests (respectively, 100, 60.0, 66.7%). Boston symptom and functional scores of RA patients with CTS diagnosed by EMG were increased than patients CTS (-) by EMG [respectively, 3.05 (1.90-4.27) vs. 1.55 (1.0-2.90), P = 0.002; 3.25 (1.73-3.82) vs. 1.12 (1.0-2.10), P = 0.008]. CTS frequency in RA was found higher than normal population, especially in patients with additional risk factors of CTS. There was no relationship between CTS and disease activity. CTS group had long disease duration and worse functional status. CTS could be a result of the chronic course in RA. In patient with CSA between 10 and 13 mm(2), Boston CTS questionnaire might give additional idea about CTS.

Comparison of research case definitions for carpal tunnel syndrome

The aim of this study was to assess agreement between different case definitions of carpal tunnel syndrome (CTS) for epidemiological studies. We performed a literature search for papers suggesting case definitions for use in epidemiological studies of CTS. Using data elements based on symptom questionnaires, hand diagrams, physical examinations, and nerve conduction studies collected from 1107 newly-hired workers, each subject in the study was classified according to each of the case definitions selected from the literature. We compared each case definition to every other case definition, using the Kappa statistic to measure pair-wise agreement on whether each subject met the case definition. We found six unique papers in a 20-year period suggesting a case definition of CTS for use in population-based studies. We extracted seven case definitions. Definitions included different parameters: (i) symptoms only, (ii) symptoms and physical examination, (iii) symptoms and either physical examination or median nerve conduction study, and (iv) symptoms and nerve conduction study. When applied to our study population, the prevalence of CTS using different case definitions ranged from 2.5-11.0%. The percentage of misclassification was between 1-10%, with generally acceptable levels of agreement (kappa values ranged from 0.30-0.85). Different case definitions resulted in widely varying prevalences of CTS. Agreement between case definitions was generally good, particularly between those that required very specific symptoms or the combination of symptoms and physical examination or nerve conduction. The agreement observed between different case definitions suggests that the results can be compared across different research studies of risk factors for CTS.

Kinematic cues for the categorization of pointing movements made by hemiparetic stroke patients

Our visual sensitivity to human movements is illustrated by our ability to recognize actions even with a minimal visual display. The present study investigates if professional expertise influences the precision of recognition and the visual cues used. We presented movements made by hemiparetic stroke patients and healthy subjects to expert (physicians and physiotherapists) and naive observers. Since stroke induces perturbations of hand trajectory and interjoint coordination, we presented two types of computer animation (one dot representing the hand and stick diagram of the upper body). The observers had to score the pathological character of the movements. The observers were able to differentiate patients according to their impairment level. The experts responded faster but, surprisingly, their responses did not differ from those of naive observers. The subjective judgment relied mainly on the quality of hand trajectory. The weak influence of postural information should be confirmed with more realistic displays.

The Result of Applying the Personal Hand Diagram for Raising the Efficacy of Handwashing and Antiseptic Handrub in Intensive Care Unit

The Result of Applying the Personal Hand Diagram for Raising the Efficacy of Handwashing and Antiseptic Handrub in Intensive Care Unit

KATZ AND STIRRAT HAND DIAGRAM REVISITED

Katz and Stirrat devised a hand diagram, which uses subjective information from the patient for the diagnosis of carpal tunnel syndrome (CTS). They reported a good result. We tested the inter-observer and intra-observer reliability of this hand diagram. Twenty five consecutive patients with a diagnosis of CTS, 25 with other common hand and wrist problems but CTS and 25 healthy individuals were prospectively recruited. Each patient filled in a hand diagram. Two experienced hand surgeon scored the diagrams blindly on two different sittings four-week apart. The intra-class correlation coefficient (ICC) and Cohen's Kappa were used for intra and inter-observer reliability respectively. The intra-observer agreement was poor (ICC 95% 0.33-0.65) and inter-observer was fair (Kappa = 0.241). This study does not support the use of Katz and Stirrat Hand Diagram for the diagnosis of carpal tunnel syndrome in place if a thorough clinical examination.

Reliability of Hand Diagrams for the Epidemiologic Case Definition of Carpal Tunnel Syndrome

The purpose of this study was to evaluate the inter-rater reliability of hand diagrams, which are commonly used in research case definitions of carpal tunnel syndrome (CTS). To evaluate the potential of non-random misclassification of cases, we also studied predictors of rater disagreement as a function of personal and work factors, and of hand symptoms not classic for CTS. Participants in a longitudinal study investigating the development of CTS completed repeated self-administered questionnaires. Three experienced clinicians, blind to subjects' work or personal history, independently rated all hand diagrams on an ordinal scale from 0 to 3. Disagreements between ratings were resolved by consensus. Reliability was measured by the weighted kappa statistic. Logistic regression models evaluated predictors of disagreement. Three hundred and thirty-three subjects completed 494 hand diagrams. Eighty-five percent were completed by self-administered questionnaire and 15% by telephone interview. Weighted kappa values representing agreement among the three raters, were 0.83 (95% CI: 0.78, 0.87) for right hand diagrams and 0.88 (95% CI: 0.83, 0.91) for left hand diagrams. Ratings from hand diagrams obtained by telephone interview produced better agreement. Agreement among raters was not affected by subjects' personal or work factors. Disagreement among raters was associated with the presence of hand/wrist symptoms other than classic CTS symptoms. Overall, high levels of agreement were attained by independent raters of hand diagrams. Personal factors did not affect agreement among raters, but presence of non-CTS symptoms seemed to affect results and should be considered in studies focused on diverse populations with heterogeneity of upper extremity symptoms.

Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome

The purpose of this paper is to assess the overlap and stability of two different case definitions of carpal tunnel syndrome CTS. The analysis considers the association between different case definitions and objective tests (sensory nerve conduction velocities, SNCVs and vibrotactile perception thresholds, TTS), and the natural history of CTS, in the context of two vibration-exposed cohorts. Clinical CTS cases were defined in two ways: (1) by the study physician using fixed criteria, and; (2) by questionnaire and hand diagram. SNCV in median and ulnar nerves was measured for digital, transpalmar, and transcarpal segments, and conventionally as from wrist-digit. Skin temperature was assessed as a point measurement by thermistor and regionally by thermal imaging. VTTs were determined at the bilateral fingertips of the third and fifth digits using a tactometer meeting the requirements of ISO 13091-1 (ISO 2001). The subjects were cohorts of shipyard workers in 2001 and 2004, and dental hygienists in 2002 and 2004. Results are reported for 214 shipyard workers in 2001 and 135 in 2004, and for 94 dental hygienists in 2002 and 66 in 2004. In 2001, 50% of shipyard workers were diagnosed as CTS cases by at least one of the diagnostic schemes, but only 20% were positive by both criteria. Among study physician diagnosed cases, 64% were CTS negative in 2001, 76% were negative in 2004, 13% were positive in both years, 22% became negative after being positive, and 11% became positive after being negative. For only study physician diagnosed CTS did VTTs differ between cases differ and non-cases in digit 3; there was no such distinction in digit 5. The dental hygienists had little CTS. Clinical case definitions of CTS based on diagrams and self-assessment, and clinical evaluation have limited overlap. Combining clinical criteria to create a more narrow or specific case definition of CTS does not appear to predict SNCV. The natural history of CTS suggests a protean disorder with considerable flux in case status over time.

A Pilot Study Comparing Two Manual Therapy Interventions for Carpal Tunnel Syndrome

Objective The purpose of this study was to determine the clinical efficacy of manual therapy interventions for relieving the signs and symptoms of carpal tunnel syndrome (CTS) by comparing 2 forms of manual therapy techniques: Graston Instrument–assisted soft tissue mobilization (GISTM) and STM administered with the clinician hands. Methods The study was a prospective comparative research design in the setting of a research laboratory. Volunteers were recruited with symptoms suggestive of CTS based upon a phone interview and confirmed by electrodiagnostic study findings, symptom characteristics, and physical examination findings during an initial screening visit. Eligible patients with CTS were randomly allocated to receive either GISTM or STM. Interventions were, on average, twice a week for 4 weeks and once a week for 2 additional weeks. Outcome measures included (1) sensory and motor nerve conduction evaluations of the median nerve; (2) subjective pain evaluations of the hand using visual analog scales and Katz hand diagrams; (3) self-reported ratings of symptom severity and functional status; and (4) clinical assessments of sensory and motor functions of the hand via physical examination procedures. Parametric and nonparametric statistics compared treated CTS hand and control hand and between the treatment interventions, across time (baseline, immediate post, and at 3 months' follow-up). Results After both manual therapy interventions, there were improvements to nerve conduction latencies, wrist strength, and wrist motion. The improvements detected by our subjective evaluations of the signs and symptoms of CTS and patient satisfaction with the treatment outcomes provided additional evidence for the clinical efficacy of these 2 manual therapies for CTS. The improvements were maintained at 3 months for both treatment interventions. Data from the control hand did not change across measurement time points. Conclusions Although the clinical improvements were not different between the 2 manual therapy techniques, which were compared prospectively, the data substantiated the clinical efficacy of conservative treatment options for mild to moderate CTS.

Carpal tunnel syndrome in male visual display terminal (VDT) workers

The association between working at a video display terminal (VDT) and development of carpal tunnel syndrome (CTS) is not well-established. The study surveyed the prevalence of CTS symptoms, explored the risk factors and evaluated the clinical application of hand diagrams, physical tests and electrodiagnosis among male VDT workers. A cross-sectional study was performed in an information and communication technology company. Three-forty questionnaires were completed and 82 volunteers participated in the physical examination and nerve conduction study. The personal and occupational risk factors for CTS were analyzed. The prevalence of CTS symptoms was 3.8% among 340 subjects, while prolonged median motor distal latency (>4.2 msec) was disclosed in 3.7% of a subgroup receiving examination. Classic/probable CTS symptoms was associated with high body mass index (>28 kg/m(2), odds ratio = 4.1, P = 0.029) and moderate job seniority (3-5 years, odds ratio = 4.6, P = 0.023). Prolonged median motor distal latency was associated with older age (>35 years old). We did not observe correlation between CTS symptoms, abnormal NCS, positive Tinel's sign or Phalen's test. The prevalence of CTS symptoms was not high among the group of male VDT workers studied. Job seniority, but not specific tasks, was associated with CTS symptoms. More reliable and valid methods to quantify the ergonomic exposure are needed to establish the association of VDT tasks and CTS.