IS NEEDLE EXAMINATION ALWAYS NECESSARY IN EVALUATION OF CARPAL-TUNNELSYNDROME

Objective: To investigate whether needle evaluation added any importan t clinical information to normal nerve conduction studies in the evalu ation of carpal tunnel syndromes. Design: Retrospective review of elec tromyography (EMG) done with the referring diagnosis of possible carpa l tunnel syndrome. Setting: Outpatients seen for EMG evaluation at one university hospital by a single electromyographer. Patients: Consecut ive sample of possible carpal tunnel syndrome patients. Interventions: None Main Outcome Measure: We determined whether needle examination w as abnormal when nerve conduction studies were normal. Results: In pat ients in whom only carpal tunnel syndrome was suspected, normal nerve conduction studies predicted that EMG would be normal 89.8% of the tim e (p = .0494). Testing based on a larger sample size might increase th e predictive value. Conclusions: There may be a subpopulation of patie nts referred for carpal tunnel syndrome who may be adequately evaluate d by nerve conduction studies alone. Additional studies will help eval uate whether this is so. (C) 1998 by the American Congress of Rehabili tation Medicine and the American Academy of Physical Medicine and Reha bilitation.