Abstract
Purpose Additional methods of diagnosing carpal tunnel syndrome (CTS) are increasingly being investigated, such as ultrasound or diagnostic tools such as carpal tunnel syndrome 6 (CTS-6), and the sensitivity and specificity of these tests are determined by the pretest probably and thereby the prevalence of a condition. It is critical that the prevalence used in these calculations accurately reflects the population undergoing these tests for a true assessment of their quality. Orthopaedic surgeons and, specifically, upper extremity specialists are most often studying these diagnostic methods, and given referral patterns, these physicians likely have a greater prevalence of CTS in their clinics than previously published for only the general population (5%). The purpose of this study is to define the prevalence of CTS in a hand surgery practice consisting of three fellowship-trained orthopaedic hand surgeons for use in future assessing the accuracy of diagnostic tests for CTS among patients presenting to a hand surgeon for evaluation.
Methods All the adult patients (≥ 18 years) who had a face-to-face encounter with an orthopaedic surgeon in this practice between January 1 and December 31, 2014 were identified. The ICD-9 code 354.0 was used to identify all patients diagnosed with CTS. The medical records of all patients with ICD-9 code were reviewed and the results of electrodiagnostic testing (EDX) documented.
Results A total 56,641 patients were evaluated by the orthopaedic department from January 1 to December 31, 2014. Of these patients, 812 (1.4%) had EDX-confirmed CTS. The prevalence of EDX-confirmed CTS was 0.2% for nonhand orthopaedic specialists and 10.7% for hand specialists. Of those seen by the hand subspecialists, 66% were female, 34% were male with the right hand affected in 42%, left in 26%, and bilateral upper extremities in 32%.
Conclusion Current literature demonstrates a prevalence of CTS among the general population of 5%. The authors have demonstrated a prevalence of CTS in an orthopaedic surgical practice to be 1.4% with a prevalence of only 0.2% noted among nonupper extremity orthopaedic specialists. They have determined the prevalence of EDX confirmed CTS in a tertiary referral hand practice to be 10.7%, much higher than the prevalence in the general population. Accurate identification of the prevalence of CTS within these patient groups is critical for statistical analysis of new diagnostic tools being developed to assess for CTS.
Level of Evidence Level IV, cross-sectional, prognostic.
Keywords
carpal tunnel syndrome - prevalence - specialty practice
