合理的な臨床検査について. この患者さんは手足トンネル症候群ですか?
1Division of Rheumatology, University of Washington Health Sciences Center, 1959 NE Pacific St, Box 356428, Seattle, WA 98195, USA. cadarcy@u.washington.edu
JAMA
|June 24, 2000
まとめ
病歴と身体検査の手術は,手首トンネル症候群 (CTS) の診断に使用されます. ハイパルゲーシア,手図,親指誘拐の強さは,CTS診断に最も役立ちます.
科学分野:
- 神経学 神経学とは
- 整形外科 整形外科 整形外科
- 診断医学 診断医学
背景:
- タイネル・サインやファレン・サインなどの履歴記録と身体検査は,手首トンネル症候群 (CTS) の診断に一般的に使用されます.
- これらの伝統的な方法の診断の正確さは,体系的な評価を必要とします.
研究 の 目的:
- 成人における手首トンネル症候群 (CTS) の診断において,経歴採取と身体検査の精度と正確さを体系的に検討する.
主な方法:
- MEDLINEと関連する記事の文献図 (1966年1月~2000年2月) を用いて,体系的な文献検索が行われました.
- CTSの疑いのある患者の身体検査の結果と電気診断検査を比較した研究も含まれていた.
- 選択された12の研究からのデータは,2人の著者によって独立してレビューされ,抽象化されました.
主要な成果:
- 中間神経領域のヒパルゲーシア (LR,3.1),古典的/確率的なカッツ手図結果 (LR,2.4),および弱い親指抽離力 (LR,1.8) がCTSを最もよく区別する.
- 不確実なカッツ手図結果 (LR,0.2) と正常な親指誘拐強度 (LR,0.5) は,CTSに反対する.
- 夜間パレステシア,ファレンとティネル症候群,テナール縮,および標準的な感覚検査は,診断価値が限られている.
結論:
- 手の症状図,下手症,親指誘拐の強度検査は,CTSの電気診断に役立ちます.
- これらの発見の信頼性は,神経伝導研究を基準基準として使用する際の制限によって制約されています.
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