The problem of the possible over-diagnosis of carpal tunnel syndrome (CTS) has been raised in the Occup Environ Med. CTS, like almost all medical conditions, occurs along a spectrum of presentation, progression and severity and, therefore, the alignment between symptoms, signs and objective tests is imperfect. A finding often misunderstood and reported in general population and workplace studies, is the dissociation between CTS symptoms and median nerve conduction slowing at the wrist. CTS symptoms and nerve conduction slowing have two different mechanisms, nerve sensory fibres autonomous discharge and conduction block (and or slowing) of the fastest nerve fibres. The two phenomena are likely due to the same causal factor, for example, compression of the median nerve in the carpal tunnel, but the processes are different, so it should not be surprising that in some individuals the onset of these changes do not occur at the same time. Furthermore, there are no internationally accepted standards for abnormal median nerve conduction at the wrist; thresholds between laboratories vary, and this variability and differences in test methods can have an impact on case classification.
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机译：Occup Environ Med提出了腕管综合症（CTS）可能过度诊断的问题。像几乎所有医疗状况一样，CTS的表现，进展和严重程度各不相同，因此，症状，体征和客观检查之间的一致性并不完美。在普通人群和工作场所研究中，一个经常被误解并发现的发现是CTS症状与腕部正中神经传导减慢之间的联系。 CTS症状和神经传导减慢具有两种不同的机制，神经感觉纤维自主放电和最快神经纤维的传导阻滞（和/或减慢）。这两种现象很可能是由于相同的因果关系所致，例如腕管正中神经受压，但是过程不同，因此，在某些人中这些变化的发作并没有发生就不足为奇了。同时。此外，还没有国际公认的腕部异常正中神经传导标准。实验室之间的阈值各不相同，这种可变性和测试方法的差异可能会影响病例分类。
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