Diagnosis of carpal tunnel syndrome.
Diagnosis of carpal tunnel syndrome.
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DOI：
10.5435/00124635-200906000-00007
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发表时间：
2009-06
期刊：
影响因子：
--
通讯作者：
Wies JL
中科院分区：
文献类型：
--
作者：
Keith MW;Masear V;Chung K;Maupin K;Andary M;Amadio PC;Barth RW;Watters WC 3rd;Goldberg MJ;Haralson RH 3rd;Turkelson CM;Wies JL
本临床实践指南旨在通过概述管理腕管综合征诊断所涉及的适当信息收集和决策过程来改善患者护理。用于制定本临床实践指南的方法旨在消除偏倚，提高透明度和促进重现性。该指南的建议如下：医生应获得准确的病史。医生应对患者进行体格检查，包括个人特征，以及进行感官检查、上肢手动肌肉测试，以及激发性和/或鉴别性测试，以进行替代诊断。医生可以进行电诊断试验来鉴别诊断。这可以在存在鱼际萎缩和/或持续麻木的情况下进行。当临床和/或激发试验呈阳性且正在考虑手术治疗时，医生应进行电诊断试验。如果医生要求进行电诊断测试，测试方案应遵循美国神经病学学会/美国神经肌肉和电诊断医学协会/美国物理医学和康复学会诊断腕管综合征的指南。此外，医生不应该用新技术对疑似腕管综合征的患者进行常规评估，如磁共振成像、计算机断层扫描和腕部和手部的压力指定感觉运动装置。该决定基于工作组面对面会议后的额外非系统文献综述。
This clinical practice guideline was created to improve patient care by outlining the appropriate information-gathering and decision-making processes involved in managing the diagnosis of carpal tunnel syndrome. The methods used to develop this clinical practice guideline were designed to combat bias, enhance transparency, and promote reproducibility. The guideline’s recommendations are as follows: The physician should obtain an accurate patient history. The physician should perform a physical examination of the patient that may include personal characteristics as well as performing a sensory examination, manual muscle testing of the upper extremity, and provocative and/or discriminatory tests for alternative diagnoses. The physician may obtain electrodiagnostic tests to differentiate among diagnoses. This may be done in the presence of thenar atrophy and/or persistent numbness. The physician should obtain electrodiagnostic tests when clinical and/or provocative tests are positive and surgical management is being considered. If the physician orders electrodiagnostic tests, the testing protocol should follow the American Academy of Neurology/American Association of Neuromuscular and Electrodiagnostic Medicine/American Academy of Physical Medicine and Rehabilitation guidelines for diagnosis of carpal tunnel syndrome. In addition, the physician should not routinely evaluate patients suspected of having carpal tunnel syndrome with new technology, such as magnetic resonance imaging, computed tomography, and pressure-specified sensorimotor devices in the wrist and hand. This decision was based on an additional nonsystematic literature review following the face-to-face meeting of the work group.
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影响因子：
4.7
作者：
Gomes, Irenio;Becker, Jefferson;Nora, Daniel Bocchese
通讯作者：
Nora, Daniel Bocchese
影响因子：
39.2
作者：
KATZ, JN;LARSON, MG;LIANG, MH
通讯作者：
LIANG, MH
影响因子：
4.4
作者：
KUNTZER, T
通讯作者：
KUNTZER, T
影响因子：
5.1
作者：
Prick, JJW;Blaauw, G;Oosterloo, SJ
通讯作者：
Oosterloo, SJ
影响因子：
3.4
作者：
Jablecki, CK;Andary, MT;Zorowitz, RD
通讯作者：
Zorowitz, RD