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February 23, 2000

Clinical Diagnosis of Carpal Tunnel Syndrome

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(8):1000-1003. doi:10.1001/jama.283.8.999

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 control subjects.

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