Median and Ulnar Neuropathies in University Cellists

2005 ◽  
Vol 20 (2) ◽  
pp. 70-76
Author(s):  
Ellie Jo Logue ◽  
Susana Bluhm ◽  
Mary Clayton Johnson ◽  
Rayna Mazer ◽  
John S Halle ◽  
...  
Keyword(s):  
Physical Examination ◽  
Upper Extremity ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Upper Extremities ◽  
School Of Music ◽  
Entrapment Neuropathies ◽  
Extensive Evaluation ◽  
Upper Extremity Injury ◽  
Musculoskeletal Function

Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Bowed string players are at risk for entrapment neuropathies in the upper extremities and are sensitive to mild neurologic deficits. The purpose of this study was to determine the presence of median and ulnar neuropathies in both upper extremities of university cellists. Fourteen volunteer cellists (ages 18-32 yrs) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music orchestras. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing sensory, motor, and F-wave nerve conduction studies. After completion of the median and ulnar nerve conduction studies, the cellists were instructed in upper extremity injury prevention exercises. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. These subjects had normal upper extremity neural and musculoskeletal function based on extensive evaluation, including a history, physical examination, and nerve conduction studies. There was no evidence of median or ulnar neuropathy at or distal to the wrist, in the forearm, across the elbow, or in the arm of the tested subjects.

Median and Ulnar Neuropathies in University Pianists

2006 ◽  
Vol 21 (1) ◽  
pp. 17-24
Author(s):  
Abigail P Gohl ◽  
Sydney Z Clayton ◽  
Kimberly Strickland ◽  
Yolanda D Bufford ◽  
John S Halle ◽  
...  
Keyword(s):  
Physical Examination ◽  
Nerve Conduction ◽  
Upper Extremities ◽  
School Of Music ◽  
Normal Limits ◽  
Entrapment Neuropathies ◽  
Extensive Evaluation ◽  
F Wave ◽  
Musculoskeletal Function ◽  
Vanderbilt University

Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Pianists and keyboard players are at risk for entrapment neuropathies in the upper extremities and are sensitive to mild neurologic deficits. The purpose of this descriptive study was to determine the presence of median and ulnar neuropathies in both upper extremities of university pianists. Nineteen volunteer male and female pianists (ages 18 to 33 yrs) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Subjects completed a history, interview, and physical examination, and nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. These subjects had normal upper extremity neural and musculoskeletal function based on extensive evaluation, including a history and physical examination. When comparing the subjects' nerve conduction study (NCS) values with a chart of normal NCS values, all electrophysiologic variables were within normal limits for motor, sensory, and central (Fwave) conduction values. However, comparison of median and ulnar motor and sensory latencies in the same and opposite hand demonstrated that 3 of the 19 pianists (16%) had early evidence of median neuropathy at or distal to the wrist. The other 16 subjects demonstrated normal comparison studies of the median and ulnar nerves in both upper extremities.

Median and Ulnar Nerve Conduction Studies in Young Adult Violinists

2000 ◽  
Vol 15 (3) ◽  
pp. 123-128
Author(s):  
Elizabeth A Bowie ◽  
Kristen M Brimer ◽  
Melissa S Kidder ◽  
Monica L Wallis ◽  
Nancy S Darr ◽  
...  
Keyword(s):  
Young Adult ◽  
Upper Extremity ◽  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Normal Values ◽  
Motor Nerve ◽  
Nerve Conduction Studies ◽  
Upper Extremities ◽  
Physical Examinations ◽  
Median Neuropathy

The incidence of musculoskeletal injuries among musicians is well documented. The purpose of this study was to describe the neural status of the median and ulnar nerves in young adult violinists. Twenty volunteer violinists were recruited from the Belmont University and the Vanderbilt University Blair School of Music Orchestras (age 18-30 years). The subjects completed a history form and underwent a physical examination. The electrophysiologic status of the median and ulnar nerves in both upper extremities was then evaluated using sensory and motor nerve conduction studies (NCSs). Upon completion of the NCSs, educational materials to prevent upper extremity cumulative trauma disorders were distributed to the subjects. In these subjects, the history and subjective examination were largely noncontributory of upper extremity neuropathies. Their physical examinations were also not diagnostic of upper extremity neuropathies. All subjects’ median and ulnar NCSs were normal when compared with a chart of normal values. However, when comparison studies between the median and ulnar NCSs in the same extremity were performed, seven subjects showed differences in their distal motor latencies (>1.0 msec) or distal sensory latencies (>0.5 msec) that could be suggestive of early median neuropathy at or distal to the wrist. In this descriptive study, 20 young adult violinists had no subjective findings of median or ulnar neuropathy, had normal physical examinations of the neck and both upper extremities, and had normal median and ulnar NCSs when compared with a chart of normal values. However, when comparison NCSs between the median and ulnar nerve in the same extremity were performed, seven violinists were found to have NCS values suggestive of early median neuropathy at or distal to the wrist. In this population of 20 young adult violinists, seven musicians were found to have electrophysiologic findings suggestive of early median neuropathy at or distal to the wrist.

scholarly journals Screening for Carpal Tunnel Syndrome in Patients With Mucopolysaccharidosis

2020 ◽  
Vol 35 (6) ◽  
pp. 410-417 ◽  
Author(s):  
Prajay Patel ◽  
Georgia Antoniou ◽  
Damian Clark ◽  
David Ketteridge ◽  
Nicole Williams
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Physical Examination ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Lysosomal Storage Diseases ◽  
Nerve Conduction Studies ◽  
Screening Methods ◽  
Lysosomal Storage ◽  
Mucopolysaccharidosis I ◽  
Tunnel Syndrome

Mucopolysaccharidoses (MPSs) are a group of rare lysosomal storage diseases with multisystem manifestations, including carpal tunnel syndrome (CTS). This study comprised a systematic review of literature and hospital guidelines addressing the method and frequency of screening for carpal tunnel syndrome in mucopolysaccharidosis patients and a review of carpal tunnel syndrome in patients seen in the multidisciplinary mucopolysaccharidosis clinic of a pediatric hospital, in order to develop screening recommendations. The literature reported the importance of routine carpal tunnel syndrome screening from early childhood in patients with mucopolysaccharidosis I, II, IV, and VI. Screening methods included physical examination, nerve conduction studies, electromyography, and ultrasonography. Ten of 20 mucopolysaccharidosis patients in our series underwent carpal tunnel syndrome surgery. Given the high incidence of carpal tunnel syndrome at a young age in mucopolysaccharidosis, the authors recommend performing physical examination and obtaining patient and caregiver history for carpal tunnel syndrome every 6 months from the time of mucopolysaccharidosis diagnosis, supplemented by annual nerve conduction studies in cases with poor history or equivocal examination.

Quadrilateral Space Syndrome: A Case Report

2017 ◽  
Vol 22 (01) ◽  
pp. 125-127 ◽  
Author(s):  
Takuya Sato ◽  
Tsai-Lung Tsai ◽  
Anas Altamimi ◽  
Tsu-Min Tsai
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Nerve Conduction ◽  
Magnetic Resonance Image ◽  
Axillary Nerve ◽  
Nerve Conduction Studies ◽  
Residual Symptoms ◽  
Arm Pain ◽  
Minimal Residual

We present a case of quadrilateral space syndrome (QSS) in a patient with left arm pain. The patient sustained a trauma to his left arm, and QSS was successfully diagnosed by physical examination, magnetic resonance image, electromyographic evaluation, and nerve conduction studies. Surgery was performed to decompress the axillary nerve and the patient recovered fully with minimal residual symptoms.

Upper Extremity Impairment Evaluation: Fifth Edition Revisions

2001 ◽  
Vol 6 (3) ◽  
pp. 1-5, 12
Author(s):  
Christopher R. Brigham ◽  
Charles N. Brooks
Keyword(s):  
Peripheral Nerve ◽  
Upper Extremity ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Fourth Edition ◽  
Strength Assessment ◽  
Sensory Deficits ◽  
Entrapment Neuropathies ◽  
New Process ◽  
Upper Extremity Impairment

Abstract Chapter 16, The Upper Extremities, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, presents several changes from the Fourth Edition. The changes are minor compared to those in Chapter 15, The Spine, but are more significant than those in Chapter 17, The Lower Extremities. This article examines some of the most important revisions, notably the more rigorous standards for upper extremity evaluation, the requirement to compare motion findings to those of the contralateral extremity, entrapment neuropathies evaluation, and strength assessment. The principles of assessment are essentially unchanged in the AMA Guides, Fifth Edition, and Section 16.1c now clarifies the process of combining assessments. The Fifth Edition provides more direction about how to measure motion, but the values for motion deficits remain the same as in the Fourth Edition. Among important changes in the Fifth Edition regarding rating peripheral nerve impairment are: grading sensory deficits, rating entrapment neuropathies, and evaluating complex regional pain syndrome. The most noteworthy changes in assessing impairment due to other disorders are the following: explicit directions about how to rate these other disorders; elimination of rating for joint crepitation; inclusion of new radiographic criteria for rating carpal instability, and introduction of a new process for rating shoulder instability. The discussion of strength is expanded in the Fifth Edition of the AMA Guides.

Evaluation of the Shoulder

2018 ◽  
pp. 1-34
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Physical Examination ◽  
Nerve Conduction ◽  
Shoulder Function ◽  
Nerve Conduction Studies ◽  
Accurate Diagnosis ◽  
Imaging Studies ◽  
Knowledge And Skills ◽  
Underlying Condition ◽  
Key Points ◽  
Patient’S History

Establishing an accurate diagnosis and understanding the severity of the underlying condition are critical in order to provide the best possible treatment for patients presenting with a painful and/or dysfunctional shoulder. Shoulder surgeons need to acquire the knowledge and skills necessary to integrate elements of the patient’s history, physical examination findings, imaging, and other studies in order to understand where the pain is coming from and how to improve shoulder function. This chapter presents an organized approach to shoulder evaluation using the author’s preferred practices, which are distinguished between general examination maneuvers to be performed on everyone and focused maneuvers directed to specific conditions. The topics include patient history; various aspects of the physical examination; imaging studies; electromyogram and nerve conduction studies; diagnostic injections; and outcome tools. The chapter concludes with key points of shoulder evaluation.

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