... in general (Section 5.4) and upper limb entrapment syndromes (Section 15.4f). The first portion of this article reviews the evaluation of upper extremity nerve impairment and summarizes inclusion criteria and causation correlation for carpal tunnel syndrome, Guyon's canal syndrome, cubital tunnel syndrome...

...James B. Talmage, MD Upper extremity entrapment neuropathies are chronic injuries to peripheral nerves, presumably from sustained pressure on the nerve in question. These conditions are controversial, and physicians disagree, unfortunately too often, about whether a neuropathy is present, what...

...James B. Talmage, MD Part 1 of this series examined many of the rules in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition, regarding rating nerve entrapment or focal neuropathies; the current article, part 2, examines how to read and match the findings...

... of motion loss, nerve injuries, entrapment disorders, and complex regional pain syndrome. This article is modified with permission from the authors of the same article published in the Fall 2021 issue of the AdMIRable Review Journal. © 2022 American Medical Association. All Rights Reserved...

... © 1999 American Medical Association. All Rights Reserved. 1999 American Medical Association In Table 16, “Upper Extremity Impairments Due to Entrapment Neuropathy” (4th ed., 57), what do “mild,” “moderate,” and “severe” mean? These degrees of severity are not defined in the table...

...% and specificities of 95% to 97%. 2 The evaluating physician must be thoughtful both in the diagnosis and in the rating of entrapment disorders. References 1. D'Arcy , CA . Does this patient have carpal tunnel syndrome? JAMA . 2000 ; 283 : 3110 – 3116 . 2. Jablecki CK , Andary MT...

... on examination. Patients present with dull, aching discomfort of the hand, forearm, or upper arm; paresthesias and tingling of the hand; subjective weakness or numbness; and, occasionally, autonomic changes. Nerve conduction velocity studies are highly accurate in documenting median nerve entrapment at the level...

... focused history-taking, including information about activities of daily living and a functional assessment tool. The criteria for diagnosis of complex regional pain syndrome have been updated for consistency with current standards and other chapters. Among other modifications, the approach to entrapment...

... at a frequency of approximately 2-5 Hz. Several manufacturers have created automated, hand-held units for performing nerve conduction studies, and neuromuscular ultrasound is noninvasive and painless, and ultrasound of nerve entrapment has identified nerve enlargement just proximal to the site of entrapment...

...Jay Blaisdell, MA; James B. Talmage, MD Like the diagnosis-based impairment (DBI) method and the range-of-motion (ROM) method for rating permanent impairment, the approach for rating compression or entrapment neuropathy in the upper extremity (eg, carpal tunnel syndrome [CTS]) is a separate...

... of common peripheral entrapment neuropathies, primarily because of its wide prevalence and associated indemnity (ie, lost work time) costs. A 3-year study of 19,937 patients reported an estimated average medical cost per case of $7,963, while indemnity costs averaged $13,475. The largest source...

...James B. Talmage, MD; Jeffrey Hazlewood, MD; J. Mark Melhorn, MD; Charles N. Brooks, MD © 2015 American Medical Association. All Rights Reserved. 2015 American Medical Association In the AMA Guides, Sixth Edition, upper limb entrapment neuropathies are rated using Section 15.4f...

... syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex...

... Guides ), Sixth Edition, has chosen to retain the use of static two-point discrimination for both acute single incident digital nerve injury and for upper extremity focal entrapment neuropathy. The authors clarify that the AMA Guides, Sixth Edition does not use two-point discrimination as a diagnostic...

... and identify questionable uses of electrodiagnosis, specifically for the evaluation of radiculopathy and focal neuropathy (eg, nerve entrapments), the two most common presentations. Some subtle abnormalities (eg, changes in motor unit recruitment pattern, changes in firing rate, or reduction in motor units...

... cord include electromyography (EMG), nerve conduction studies, and somatosensory evoked potentials. The primary uses of these tests are to evaluate radiculopathy, entrapment neuropathy, or other peripheral nerve study, and results must be presented completely, concisely, and in a standardized format...

... entrapment at the elbow (cubital tunnel syndrome). The AMA Guides, Sixth Edition, does not include a listing for quadrilateral space syndrome, and the author discusses the challenges of teasing out functional limitations when multiple diagnoses are present within the same limb. Evaluators should note...

..., 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...