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February 23, 2000

Clinical Diagnosis of Carpal Tunnel Syndrome—Reply

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

In Reply: Both Dr Cosgrove and Dr Stark appear to have misread our position with respect to MRI and intracarpal canal pressures (ICCPs). We do not advocate use of MRI or measurement of ICCP in the routine clinical evaluation of CTS at this time. We believe that MRI and ICCP are 2 test procedures (and there may be others) that deserve further scientific and clinical assessment to determine if they may enhance our ability to more accurately diagnosis CTS, particularly in cases that are not classic or are being considered for surgery. We believe that many patients with CTS, if not the majority, do not present in a classic manner; that is why tests such as nerve conduction studies have assumed such importance. Unfortunately, the interpretation of nerve conduction studies is not necessarily as straightforward as is commonly assumed, which was one of the main points of our Editorial.

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