Liverpool carpal tunnel scoring system to predict nerve conduction study results: A prospective correlation study

Area of Science:

• Neurology
• Clinical Diagnostics
• Medical Research

Background:

• Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder.
• Clinical assessment is standard, but the necessity of nerve conduction studies (NCS) for management decisions is debated.
• Accurate assessment of CTS severity is crucial for effective treatment.

Purpose of the Study:

• To develop and validate a scoring system correlating clinical symptoms, signs, and risk factors with NCS findings in CTS patients.
• To establish a reliable method for predicting NCS severity based on clinical evaluation.
• To address the debate on the utility of investigations in CTS assessment.

Main Methods:

• A prospective correlation study involving 59 patients with CTS.
• A novel scoring system was developed, incorporating four symptoms (tingling, numbness, nocturnal paresthesia, bilateral symptoms) and four clinical signs (thumb abduction, Tinel's, Phalen's, hypoalgesia).
• Risk factors including age (>40) and female sex were included; NCS results were categorized as normal, mild, moderate, or severe.

Main Results:

• The study analyzed 61 scores from 59 patients.
• Mean scores showed a correlation with NCS severity: 6.75 (normal NCS), 5.50 (mild NCS), 9.17 (moderate NCS), and 9 (severe NCS).
• An Eta score of 0.822 indicated a strong association between the CTS scoring system and NCS severity, with scores ≥8 generally matching moderate to severe NCS findings.

Conclusions:

• A simple clinical scoring system can effectively predict and correlate with the severity of NCS findings in carpal tunnel syndrome.
• This scoring system offers a valuable tool for clinicians in assessing CTS severity.
• The findings support the integration of this scoring system into routine CTS evaluation.