RT Journal
A1 Keith, Michael Warren
A1 Masear, Victoria
A1 Chung, Kevin C.
A1 Maupin, Kent
A1 Andary, Michael
A1 Amadio, Peter C.
A1 WattersIII, William C.
A1 Goldberg, Michael J.
A1 HaralsonIII, Robert H.
A1 Turkelson, Charles M.
A1 Wies, Janet L.
A1 McGowan, Richard
T1 American Academy of Orthopaedic Surgeons Clinical Practice Guideline onDiagnosis of Carpal Tunnel Syndrome
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2009
FD October 1
VO 91
IS 10
SP 2478
OP 2479
DO 10.2106/JBJS.I.00643
UL http://dx.doi.org/10.2106/JBJS.I.00643
AB 
Summary of RecommendationsRecommendation 1.1 The physician should obtain an accurate patient history (Level V, Grade C).Recommendation 2.1 The physician should perform a physical examination of the patient that may include:personal characteristics (Level V, Grade C)performing a sensory examination (Level V, Grade C)performing manual muscle testing of the upper extremity (Level V, Grade C)performing provocative tests (Level V, Grade C), and/orperforming discriminatory tests for alternative diagnoses (Level V, Grade C).Recommendation 3.1a The physician may obtain electrodiagnostic tests to differentiate among diagnoses. (Level V, Grade C)Recommendation 3.1b The physician may obtain electrodiagnostic tests in the presence of thenar atrophy and/or persistent numbness (Level V, Grade C).Recommendation 3.1c The physician should obtain electrodiagnostic tests if clinical and/or provocative tests are positive and surgical management is being considered (Level II and III, Grade B)Recommendation 3.2 If the physician orders electrodiagnostic tests, the testing protocol should follow the AAN/AANEM/AAPMR guidelines for diagnosis of CTS (Level IV and V, Grade C).Recommendation 3.3 The physician should not routinely evaluate patients suspected of having carpal tunnel syndrome with new technology, such as magnetic resonance imaging (MRI), computerized axial tomography (CAT) and pressure specified sensorimotor devices (PSSD) in the wrist and hand. (Level V, Grade C).