carpal tunnel syndrom scoring

Carpal Tunnel Syndrome Scoring

Scored questionnaire versus EMG testing
A scored questionnaire can replace nerve conduction studies in the initial assessment of patients presenting with CTS.
The questionnaire is based on the work of Levine et al4 and has been validated in secondary care for the diagnosis of CTS by Kamath and Stothard.3 The results gave a sensitivity of 85% for the scored questionnaire compared to 92% for nerve conduction studies. Importantly the positive predictive value was 90% for the questionnaire and 92% for the nerve conduction studies. Symptom relief was taken as the 'gold standard' for true carpal tunnel syndrome.

Clinical questionnaire for the diagnosis of CTS*

INSTRUCTIONS: Circle YES or NO and the score either + or –
Has pain in the wrist woken you at night?
YES 1	NO 0
Has tingling and numbness in your hand woken you during the night?
YES 1	NO 0
Has tingling and numbness in your hand been more pronounced first thing in the morning?
YES 1	NO 0
Do you have/perform any trick movements to make the tingling, numbness go from your hands?
YES 1	NO 0
Do you have tingling and numbness in your little finger at any time?
YES 0	NO 3
Has tingling and numbness presented when you were reading a newspaper, steering a car or knitting?
YES 1	NO 0
Do you have any neck pain?
YES –1	NO 0
Has the tingling and numbness in your hand been severe during pregnancy?
YES 1	NO –1	N/A 0
Has wearing a splint on your wrist helped the tingling and numbness?
YES 2	NO 0	N/A 0

TOTAL: .........................

A score of 3 or more has been submitted to analysis in comparison with nerve conduction studies.
A score of 5 or more is recommended for use of the test as a diagnostic screening tool to replace nerve conduction studies.

* Reproduced from Appendix A from J Hand Surg [Br] 29(1):95-6 Kamath and Stothard, 'Erratum to: A clinical questionnaire for the diagnosis of carpal tunnel syndrome'. © 2004 The British Society for Surgery of the Hand.