do i have cts

At the end of the questionnaire the site will give you six numbers - 4 of these are decimal numbers in the format x.xx - two for the left hand and two for the right hand - these numbers are a measure of how bad your symptoms feel to you. The other two numbers are percentages in the format xx% - your probability of having CTS is the higher of these two numbers - they are labelled ANN and LRP in the My CTS summary screen and are calculated by two different mathematical methods. This results should be viewed as an 'intelligent guess' about your diagnosis. A few patients with very low scores (<20%) do turn out to have evidence of CTS when tested, and a few patients with very high scores (>70%) turn out to have no definite evidence of CTS - so the estimate obtained from the questionnaire should be treated as just that - an estimate. JB

I understand the scoring system, but would like to ask if there is a level at which it is better to omit splinting, and refer directly for EMG/ or are we better adviced to try splinting in all but the most severe. The scoring system does not (obviously) tell us what the Symptom Severity Score is marked out of-- could you elucidate? Thanks

I'm aware that the scores are a bit cryptic at present and sometimes need some further explanation. We will be trying to improve this in the next iteration of the website. The Boston/Levine severity assessment tool is referenced in the questionnaire as I needed copyright permission from the original publisher to use it in this form and it is discussed elsewhere on the site The SSS (Symptom severity score) and FSS (Functional severity score) can each range from 1 - no symptoms at all to 5 - the worst possible symptoms. They are not much use as a guide to treatment having very lpoor correlations with both the nerve conduction studies and the outcome of therapy so they really are a tool for measuring progress, not for deciding management or diagnosis. I would try splinting in everyone in primary care - even the worst cases of CTS can benefit subjectively.I would then refer on for EMG every patient who does not respond adequately to splints and whose diagnostic probability on here is above 20%. If you want to cut down on EMGs you can adopt a higher referral threshold percentage but will miss more treatable CTS that way. I hope to be publishing the figures for this shortly.

I'll move your posting and this reply into the website issues forum in a few days as it is really of general relevance rather than relating to an individual patient. JB