Article

A limited amount of research has investigated the potential
relationship between carpal tunnel syndrome (CTS) and thoracic outlet
dysfunction. PURPOSE OF THE STUDY: To compare the prevalence of positive clinical
tests suggestive of disputed neurogenic thoracic outlet syndrome (TOS) in
subjects with CTS (CTS+) with that of subjects without CTS (control). STUDY
DESIGN: Case-control study. METHODS: Subjects with electrodiagnostically
confirmed CTS (CTS+) were recruited consecutively and matched by age (+/-2 years)
and gender with asymptomatic (control) subjects. Subjects underwent clinical
testing for neurogenic TOS using two provocative tests: modified Cyriax release
test and elevated arm stress test (EAST). Subjects were tested for the presence
of an elevated first rib using cervical rotation lateral flexion (CRLF) test.
RESULTS: A total of 32 investigational subjects and 32 matched control subjects
was included in each group (mean age: 43.5+5.9 years). A significantly greater
number of CTS+ subjects presented with positive provocative testing for TOS
(modified Cyriax release test p=0.005; EAST approached significance p=0.027) and
for the presence of an elevated first rib (CRLF test p=0.003) as compared with
controls. The likelihood of neck pain, shoulder pain, or an elevated first rib
was 16 times greater in the CTS+ group as compared with that in the control
group. CONCLUSIONS: A greater number of subjects with CTS presented with proximal
dysfunctions suggestive of TOS and history of neck and shoulder pain. Evaluation
of proximal structures involved with thoracic outlet dysfunction in persons with
CTS has clinical merit. LEVEL OF EVIDENCE: Level III-b.
CI - Copyright (c) 2011 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS