 |
|
Concurrent Medical Disease in Work-Related Carpal Tunnel Syndrome
Steven G. Atcheson, MD;
John R. Ward, MD;
Wing Lowe, PhD
Arch Intern Med. 1998;158:1506-1512.
Background Work-related carpal tunnel syndrome (CTS) now accounts for more than 41% of all repetitive motion disorders in the United States. Carpal tunnel syndrome is also associated with obesity and many different medical diseases.
Patients and Methods Two hundred ninety-seven patients medically certified with a work-related upper extremity industrial illness underwent a systematic search for concurrent medical diseases. Diagnoses of CTS were made using 4 separate case definitions.
Results One hundred nine separate atraumatic illnesses (mainly hypothyroidism, diabetes mellitus, and various arthropathies) capable of causing arm pain or CTS were diagnosed in a third of all patients. Using record reviews and patient histories alone, 68% of these conditions would have been missed. One hundred ninety-eight patients had been diagnosed as having CTS 420 times in more than 1000 office visits, but diagnostic laboratory studies were ordered only 25 times. Every case definition of CTS was significantly associated with a related medical condition. Two definitions yielded more than 41% prevalence of concurrent disease (odds ratio,  2.36; P .004), and up to two thirds of these patients had either a medical disease or were obese (odds ratio, 3.15; P.001). Two cohorts totaling 114 patients (38%) working for companies employing nearly 19000 people included all CTS claims filed during 2 evaluation periods. They did not differ from the other patients with CTS with respect to age, concurrent disease, or obesity.
Conclusions Routine patient histories and record reviews are inadequate for proper evaluation of work-related CTS. Unrecognized medical diseases capable of causing CTS are common. Studies asserting an association between occupational hand usage and CTS are of questionable validity unless they prospectively account for confounding disease and obesity.
From the Arthritis Specialists of Northern Nevada, Reno (Dr Atcheson); University of Utah School of Medicine, Salt Lake City (Dr Ward); and Center for Biomedical Modeling Research, University of Nevada School of Medicine, Reno (Dr Lowe).
RELATED LETTER
Work-Related Carpal Tunnel Syndrome: Fix the Jobs; Don't Blame the Workers
Susan Burt, Thomas Hales, and Steven G. Atcheson
Arch Intern Med. 1999;159(12):1371-1373.
EXTRACT
| FULL TEXT
RELATED ARTICLE
The Many Faces of Carpal Tunnel Syndrome
David E. Yocum
Arch Intern Med. 1998;158(14):1496.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Women gain weight and fat mass despite lipectomy at abdominoplasty and breast reduction
Rinomhota et al.
Eur J Endocrinol 2008;158:349-352.
ABSTRACT
| FULL TEXT
Does a carpal tunnel syndrome predict an underlying disease?
de Rijk et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:635-637.
ABSTRACT
| FULL TEXT
Carpal Tunnel Syndrome As an Occupational Disease
Kao
J Am Board Fam Med 2003;16:533-542.
ABSTRACT
| FULL TEXT
Computer Use and Risk of Carpal Tunnel Syndrome
Nathan et al.
JAMA 2003;290:1853-1854.
FULL TEXT
Indications for Requesting Laboratory Tests for Concurrent Diseases in Patients with Carpal Tunnel Syndrome: A Systematic Review
van Dijk et al.
Clin. Chem. 2003;49:1437-1444.
ABSTRACT
| FULL TEXT
Computer Use and Carpal Tunnel Syndrome: A 1-Year Follow-up Study
Andersen et al.
JAMA 2003;289:2963-2969.
ABSTRACT
| FULL TEXT
Unusual entrapment neuropathy in a golf player
White et al.
Neurology 2003;60:885-885.
FULL TEXT
Carpal Tunnel Syndrome
Katz and Simmons
NEJM 2002;346:1807-1812.
FULL TEXT
Work-Related Carpal Tunnel Syndrome: Fix the Jobs; Don't Blame the Workers
Burt et al.
Arch Intern Med 1999;159:1371-1373.
FULL TEXT
Carpal Tunnel Syndrome in the Workplace
Romano
Arch Intern Med 1999;159:1008-1008.
FULL TEXT
Risk Factors for Carpal Tunnel Syndrome
Gerr et al.
Arch Intern Med 1999;159:1008-1010.
FULL TEXT
The Many Faces of Carpal Tunnel Syndrome
Yocum
Arch Intern Med 1998;158:1496-1496.
FULL TEXT
|
