|Home | About | Journals | Submit | Contact Us | Français|
Screening patients with typical carpal tunnel syndrome for underlying conditions is not warranted, according to a large retrospective study, and the first formal assessment.
Diabetes mellitus, hypothyroidism, and connective tissue disease, including rheumatic conditions, are reputedly associated with carpal tunnel syndrome, but testing a cohort of 516 patients with the syndrome disclosed only a handful of these newly diagnosed conditions: two cases of diabetes and two of hypothyroidism. The low positive predictive values of carpal tunnel syndrome for these conditions was therefore too low to make screening worth while, requiring more than 200 patients to be tested for each new case of diabetes or hypothyroidism. Carpal tunnel syndrome was not associated with any case of connective tissue disease.
This was a two centre hospital study in the Netherlands on consecutive patients in each with carpal tunnel syndrome. Blood tests for non‐fasting glucose, thyroid stimulating hormone, and erythrocyte sedimentation rate were checked and patients with positive results excluded from further testing. Patients with normal test results were retrospectively followed up to check for diagnoses by hospital information systems and data from general practitioners. Although the patients come from a much selected, hospital based population, the study's authors do not think this had a material effect.
Exploiting the apparent link with carpal tunnel syndrome and screening for diabetes mellitus, hypothyroidism, and connective tissue disease might have been worth while if carpal tunnel syndrome had turned out to be the common presenting symptom.
De Rijk MC, et al. Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:635–637.
Please visit the Annals of the Rheumatic Diseases website [www. annrheumdis. com] for a link to the full text of this article.