CARPAL-TUNNEL SYNDROME - A PROSPECTIVE CLINICAL-STUDY OF 100 CASES

Objectives: To determine the clinical profile, the associated disorder s and risk factors of carpal tunnel syndrome (CTS) in Saudi patients a nd to assess the sensitivity and specificity of the clinical tests des cribed in this syndrome. Methods: A hundred consecutive patients refer red to the clinical neurophysiology laboratory and found to have clini cal and electrophysiological unilateral or bilateral CTS were examined prospectively and subjected to a comprehensive questionnaire, Compara tive data extracted from community-based studies and adjusted for age and sex were used to establish the risk factors of CTS. Results: Femal es (n=82) outnumbered males both for unilateral (20/7) and bilateral ( 62/11) CTS. Tinel's sign Sensitivity was 67% and its specificity 78%. For Phalen's sign, the values were 68% and 63% respectively. Most comm on associated disorders were obesity (84%), diabetes mellitus (30%),os teoarthritis (25%) and hypothyroidism (9%). When the frequencies of th ese disorders were compared with their prevalence rates in the communi ty, the most important risk factors for CTS development were female ge nder (Odds' ratio 4.5), diabetes mellitus in men (OR 6.39) and women ( OR 3.78) and obesity in women (OR 2.17). Conclusion; CTS was 4.5 times more common in Saudi women than men. Diabetes mellitus and obesity we re the most important risk factors. However the presence af diabetes m ellitus increased the risk of CTS in men more than in women. The Tinel 's and Phalen's signs had similar sensitivity of about 66% in electrop hysiologically diagnosed CTS while the Tinel's sign was more specific (78% vs 63%).