Differentiating HAVS and CTS

Differentiation of hand –arm vibration syndrome (HAVS) and carpal tunnel syndrome (CTS) may be difficult. However, there are a number of symptoms and clinical findings that may indicate that one or the other is more likely. It is possible that a number of cases previously diagnosed as sensorineural HAVS did in fact have CTS; that could explain the perception of similarity of symptoms. A low threshold of suspicion of CTS is recommended in all cases of paraesthesiae in the hands or digits—reflecting Phalen’s approach to CTS being that ‘a patient with any numbness or tingling in the fingers or with any weakness or atrophy of the thenar muscles must be considered as having carpal tunnel syndrome’. However Stromberget al. carried out fractionated nerve conduction, vibrotactile and temperature thresholds in symptomatic vibration-exposed workers [1] and concluded that ‘distal injuries to the receptors or nerves in the fingertips, CTS, and vibration-induced neural changes in the carpal tunnel that all mimic each other clinically, may occur either as isolated or combined phenomena’.
Source: Occupational Medicine - Category: Respiratory Medicine Source Type: research