Houston Methodist. Leading Medicine

Hand FAQ

Question:

I've been told by my doctor that she thinks I have carpal tunnel syndrome. I don't have insurance, so further testing is out of the question. But I can't help but wonder if having an MRI would be worth the out-of-pocket expense. What do you think?

Answer:

Everyone likes to have a visual picture of what's happening to them to cause their various symptoms. But sometimes the added expense doesn't really yield the results we are looking for. In the case of carpal tunnel syndrome (CTS), experts from the American Academy of Orthopaedic Surgeons (AAOS) suggest you can save your money. When the physician takes the clinical picture (signs and symptoms reported by the patient) and adds it to the results of clinical tests and electrodiagnostic tests (if needed), the diagnosis is more likely to be accurate. The combination of this data also makes it easier to formulate a plan of care. There is a need for research to find out which tests give the most accurate information and can be relied on to make the diagnosis. This could be a cost-cutting measure as well. Studies show that advanced imaging studies such as CT scans or MRIs don't improve the sensitivity or specificity needed in making the diagnosis of carpal tunnel syndrome. The physician's interview of the patient and clinical exam are usually quite enough to make an accurate diagnosis and move on to the treatment plan. The quicker a patient is moved from diagnosis to intervention, the better the chance for an improved outcome. Michael Warren Keith, MD, et al. AAOS Clinical Practice Guideline Summary. Diagnosis of Carpal Tunnel Syndrome. June 2009. Vol. 17. No. 6. Pp. 389-396.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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