Diagnosing Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that doctors classify as a “repetitive strain injury,” meaning that carpal tunnel does not just happen after one injury, but as the result of repeated overuse of the tendons surrounding the median nerve in the wrist. The median nerve controls the movement and feeling in the wrist, up through the palms and fingers and when this nerve experiences long-term pressure, carpal tunnel syndrome can occur.

Symptoms of carpal tunnel syndrome include: definitive wrist pain spreading into the arm, tingling or numb feeling in the fingers and palm, inability to determine temperature in the fingers, and loss of movement in the wrist, palm and fingers. If left untreated, carpal tunnel can cause the muscles in the hand, especially the thumb, to waste away and become less usable. Carpal tunnel syndrome is seen most often in those that work around computers, avid video game players, or those in assembly line employment: sewing, cleaning or packaging.

The traditional way to determine carpal tunnel treatment was through a physical examination called a Tinel test, in which the treating physician applies slight pressure to the median nerve, usually causing a shock of pain through the patient’s hand. There is also the Phalen test where the patient is asked to hold the back of the hands together with arms out for upwards of 2 minutes. If these tests proved to be inconclusive, most doctors will use electrodiagnostic tests by inserting electric shock into the nerve and measuring the speed in which the signal is transmitted. This process begins by inserting a fine needle into the muscle surrounding the median nerve and applying electrodes into the muscle to determine the degree of damage.

Ultrasound accurate in confirming carpal tunnel syndrome

According to a 2014 article published in the Journal of Bone and Joint Surgery, ultrasound technology is helpful at determining Carpal Tunnel Syndrome.

Orthopedic doctors have found that ultrasound technology may be more effective in determining if a patient has carpal tunnel syndrome. Ultrasounds are used to show if the median nerve is experiencing any impairment as a result of arthritis, muscle tears, or tendonitis.  Ultrasound, especially modern digital ultrasounds, had high sensitivity to carpal tunnel in laboratory studies in comparison to the electrodiagnostic testing. In summary “ultrasound was accurate in 89% of cases and electrodiagnostic testing was accurate in 86% of cases” highlighting that the simpler and less expensive ultrasound technology can determine carpal tunnel syndrome.

Ultrasounds use the power of sound waves in order to produce images. Without any invasive properties, shots or radiation, ultrasounds are safe and comfortable to patients in comparison to needles and electric shocks and they offer invaluable information.

At Doctors Imaging in Metairie, we use the Phillips digital ultrasound, a state of the art machine that creates clear and concise images for doctors and can help your hand doctor to determine whether medication, physical therapy or surgery is necessary for those suffering from carpal tunnel syndrome. For more information, look through our Ultrasound Page or call us at 504-883-8111 to schedule your ultrasound appointment.

Which is Better: CT or PET Scans for Cancer?

One of the more interesting elements of working in the medical field is that as technology and research advances, what we once believed to be the best method may not be. Where people once thought that butter was good for burns and that smoking wasn’t harmful, we now know better. The world of medical imaging is similar. As the technology advances, more studies are done for different diseases, and we are quickly learning that some of the standard ways of thinking might be subject to change.

Just recently, a new article was published in the Oncology Journal by Cancer Network showed that in one recent study where CTs were the premier choice for finding cancer and determining the degree of disease. CTs or computed tomography, uses computer technology and x-ray in order to create cross-sectional images that physicians glean information. CTs are beneficial when searching for cancer because CTs create cross-sectional images, allowing doctors to see deep into the body through organs, bones, vessels and other blockages. By making cross-sectional images, CTs can examine one section of the organ or area from a multitude of angles. For cancer in the beginning stages, it can very difficult to determine where it is located exactly and where in the body a biopsy needs to be performed.

That is why testing our old ways of thinking is so crucial in this field of medicine. This most recent article found that PET scans for cancer are more beneficial at finding and determining the extent of follicular lymphoma, a form of cancer in which cells a circular pattern in the lymph nodes. There are so many kinds of follicular lymphoma that classifying one in a patient can be difficult even for oncologists. 1 out 5 of every kind of lymphatic cancer is follicular lymphoma making it a common form of cancer and thus all the more important to have the best kind of procedure to go about diagnosing the disease.

PET scans can be used for determining a number of conditions. Most often PET scans for cancer, some cardiovascular problems and a few brain disorders. According to this recent study, PET-CT scans are more proficient at finding follicular lymphoma than contrast-enhanced CT. Contrast material is commonly used in CT scans as a ways for doctors to determine areas of increased or decreased blood flow and to increase the visibility of body tissue or blood vessels. Sometimes contrast material is administered orally to outline the digestive tract and sometimes and intravenous injection is needed to see if body organs are behaving abnormally and/or  possible tumors are present. In PET-CT scans for cancer or heart and brain health, a small dosages of radioactive drug is used to show the differences between healthy and diseased tissue. The radioactive material requires about 30-90 minutes to travel through the body in order to show up on the scan. Do not be alarmed by the use of the word “radioactive.” We use this term to mean that it will react to the PET-CT scan and provides a higher level of contrast which is particularly beneficial when trying to spot difficult to find cancer cells. When it comes to cancer cells, you want to be more than thorough, you want to be exact.