Question

Case presentation:  Mrs. Lianne Thomson, a Caucasian female of 45 years old with a BMI of 26, presents to the office with dull ache pain and tingling over the right hand, wrist and elbow.  She is a full-time massage therapist with a career of 15 years  and her pain is gradually getting worse during the last month. Symptoms started about two months ago apparently during her long shifts while she is working. This pain is rated as a 5 or 6 out of 10 and increases in intensity specially after a long day at work. Patient have not experienced this type of pain before and there's a remarkable past medical, social and family history.  

List 4 Wrist/Hand orthopedic test you think would be positive for this case

Answer 1

Mrs.Lianne Thomson having dull ache pain and tingling over right hand ,wrist and elbow that may be diagnosed as Carpal tunnel syndrome based on the signs and symptom.Conformation of the disease can be detected by some of the diagnostic test.

Carpal tunnel syndrome is the most common compressive entrapment neuropathy caused by the compression of median nerve at the space arund the wrist known as the carpal tunnel.The epidiological factors are genetic ,medical social,vocationl,and demographic factors.If left untreated ,it can lead to irreversible median nerve damage,causing a loss of hand function.BMI has been attributed as a risk factor for the development of CTS.An obese individual had 2.5 times higher probability of compared to a slender.

list of the test used for the detection of the CTS are;

1.Tinel's sign-In this test the doctor will tap or press on the median nerve in the patient wrist with a reflex hammer. if the fingers tingle or if the patient feel an electric shock like sensation,the test is positive as to conform patient having carpal tunnel syndrome.

2.Phalen's Maneuver-this test also known as wrist -flexion test,The doctor tell to the patient to press the back of our hands and fingers together with our wrists flexed and your fingers pointed down, then to stay that way for 1-2 minutes. if that feel fingers are tingle or get numb then finalize test is positiveand conform patient having CTS.

3.Two Point Discrimination Test-In this test means if the patient tell if two objects touching their skin are two distinct points insted of just one.the doctor may use gadget called 2-point disk-criminator,a small flat,eight -sided tool with needle like prongs sticking out from all sides.He might do the test several times on each finger.he will start with two points touching our skin a few centimeter apart and move them closer together until we feel just one point of pressure,The distance at which we feel only one point will help him figure out nerve function and compression these are two important components of CTS.

4.Nerve Conduction Velocity Test-this is the most accurate test used top detect CTS.it measures how fast an electric signal can travel along a nerve or from the nerve to a muscle.;The doctor pace a small electrode on our skin near your elbow,it sends mild electrical current down your median nerve. the more time it takes for current down your median nerve.The more time it takes for the current to travel from elbow to our fingers,the more damage to the persons median nerve,

5.Electomyogram-The doctor place a small needle electrode into muscles in the hand and arms that get impulses into the muscle,then relax and flex the hand several times.the doctor can tell if our median nerve is damaged or being squeezed.

6-Ultrasound,X-ray,MRI

these are the diagnostic test can be used to detect the condition,based on the result start treatments.