8th International Conference of Orthopedic Surgeons and Rheumatology

Biography

Biography: Yasser El Miedany

Abstract

Evaluation of patients presenting with carpal tunnel syndrome (CTS) symptoms has long relied on their clinical assessment as well as nerve conduction studies. However, whilst standard symptoms and positive provocative testing may enable identifying some of the cases, the subjectivity and sensitivity of these measures results in very poor reliability and diagnostic accuracy. Similarly, though studies revealed sensitivity and specificity data in favour of electrodiagnostic testing for the CTS diagnosis, abnormal nerve conduction testing results do not necessarily equate to the correct diagnosis.  Nerve conduction studies can be normal in early cases. Furthermore, nerve studies were reported as not sensitive to change or management, hence, a poor predictor of treatment outcomes. Inspite of some limitations, ultrasonography was found to be a good tool not only for the CTS diagnosis, but also for identifying the median affection severity. The search for markers identifying key targets for the assessment of major outcomes in musculoskeletal diseases has become one of the hot issues in rheumatology. Possible markers should be objectively measured, indicatory of normal biology as well as the pathologic process, indicator of response to therapy and prognosis. It should also be a good indicator of modification of the pathological process and help to identify (in early cases) the patients who are going to respond quickly to therapy with the vision to tailor management to the patient status. This presentation will discuss the outcomes of a recent study investigating the feasibility of initial CTS assessment parameters for setting up a treatment plan tailored to the patient’s needs and its ability to predict treatment outcomes.