Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
To the Editor: In the epidemiologic study by
Dr Atroshi and colleagues1 estimating the
prevalence of CTS in a general population, the nerve conduction studies may
have been performed incorrectly. Nerve conduction testing technique and normal
values for this study were those described by Kimura,2
who recommended warming of the limbs if the skin temperature is below 34°C.
Atroshi et al measured skin temperatures of their subjects, but the subjects'
hands were not warmed unless their temperature was less than 30°C. Therefore,
the temperature requirements used by Atroshi et al will lead to a higher percentage
of false-positive results in all clinical categories in their study, which
would explain the high percentage of abnormal results (18.4%) in their nonsymptomatic
Corwin HM. Clinical Diagnosis of Carpal Tunnel Syndrome. JAMA. 2000;283(8):1000-1003. doi:10.1001/jama.283.8.999