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      Dor e parestesias nos membros superiores e diagnóstico da síndrome do túnel do carpo Translated title: Pain and numbness in the arms and hands and carpal tunnel syndrome diagnosis

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          Abstract

          Nós avaliamos a freqüência e localização de dor e parestesias em pacientes com síndrome do túnel do carpo (STC) e em indivíduos da população geral, pareados por gênero e idade. Determinamos a sensibilidade e a especificidade desses sintomas para o diagnóstico de STC. Dor foi um sintoma comum nos dois grupos de pacientes. Parestesia ocorreu com mais freqüência em pacientes com STC (p<0,05). No grupo com STC, a dor era localizada no pescoço (42,8%), membros superiores (36,8%) e mãos (82,8%). Nos pacientes sem STC, a dor se localizava na cabeça (11,4%), região axial (37,1%) e membros inferiores (22,8%). Nós concluímos que, em relação ao diagnóstico de STC, dor e parestesias apresentam sensibilidade baixa e especificidade alta quando as queixas estão presentes nos membros superiores; e sensibilidade e especificidade altas (>75%) quando são localizadas nas mãos.

          Translated abstract

          We studied the frequency and localization of pain and numbness in patients with carpal tunnel syndrome (CTS), in comparison with individuals of the general population, matched for sex and age, and we determined the sensitivity and the specificity of these symptoms for the CTS diagnosis. Pain was a common symptom in the two groups of patients. Numbness occurred more frequently in CTS group (p<0.05). In CTS patients, pain complaints were present in neck (42.8%), arms (36.8%) and hands (82.8%). Among controls, pain was more common in head (11.4%), trunk (37.1%), legs (22.8%). In our casuistics, in relation to the CTS diagnosis, the presence of pain and numbness have low sensitivity and high specificity when they occur in the arms, and high sensitivity and specificity when they occur in the hands.

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          Most cited references19

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          Síndrome do túnel do carpo: aspectos clínico-epidemiológicos em 668 casos

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            Musculoskeletal pain in the community.

            To estimate the prevalence of musculoskeletal (MSK) pain in Al-Qaseem province in central Saudi Arabia. Over a period of 18 months extending from September 1993 through to the end of February 1995, a house-to-house survey was conducted in Al-Qaseem province and included 5,894 adults asking regarding musculoskeletal pain. We obtained a response from 5,823 (98.8%), 2,667 (45.8%) men, and 3,156 (54.2%) women. The mean age was 34.14 +/- 15.16 years. Musculoskeletal pain was reported by 1,477 (25.4%), 762 (13.1%) men and 715 (12.3%) women. Musculoskeletal pain was significantly correlated with age (r =0.454), married status (r=0.238), unemployment (r=0.122), lower educational attainment (r=0.347), frequent attendance at local doctor (r=0.703), consumption of medications for pain (r =0.551), and change in ability to work (r=0.492). We found no association with sex or body mass index. Musculoskeletal pain, although common in the community, is less prevalent than reported from Western countries, but has similar socio-medical consequences.
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              Validation of a diagnostic sign in carpal tunnel syndrome.

              Of three signs in carpal tunnel syndrome, Phalen's, Tinel's and the Flick sign, the last of these was the most valid and reliable. The presence of a positive Flick sign predicted electrodiagnostic abnormality in 93% of cases and had a false positive rate of under 5% among other neural lesions in the arm. The key question consists of an enquiry as to what the patient does with the affected hand at times when symptoms are at their worst; a flicking movement of the wrist and fingers demonstrated by the patient constitutes a positive response.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                December 2006
                : 64
                : 4
                : 997-1000
                Affiliations
                [1 ] Universidade Estadual da Paraíba Brazil
                [2 ] Universidade Estadual da Paraíba Brazil
                Article
                S0004-282X2006000600021
                10.1590/S0004-282X2006000600021
                0c644aba-25c2-4ca2-aeb3-7294384ff9e5

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                carpal tunnel syndrome,median nerve,conduction nerve,pain and numbness,diagnosis,síndrome do túnel do carpo,nervo mediano,diagnóstico,eletroneurografia,dor,parestesias

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