|
Carpal Tunnel Syndrome:
|
Exclude from Consideration if:
|
|
Case if meets: (1 + 2 + 3 + 4) OR 5
|
· had both tingling/numbness and an abnormal nerve study at baseline (met the prevalence case definition, hand specific1)
|
|
1. Numbness/Tingling (N/T) in 2 or more median nerve served digits (thumb, index, middle finger and/or ring finger) for ≥25% of days and/or nights on at least 2 consecutive monthly followups (from monthly follow-up interview). Note: N/T at baseline counts as one of two consecutive followups).
| |
| |
· has evidence of systemic neuropathy (determined by JJW, censor for all CTS analyses)
|
| |
· had prior Carpal Tunnel Release surgery (hand specific1)
|
| |
· had prior diagnosis of CTS by a Physician (hand specific1)
|
|
2. Abnormal nerve conduction study consistent with median mononeuropathy at the wrist (from baseline, or semiannual NCS) that was independently interpreted by a blinded, board certified physical medicine and rehabilitation physician (JW).
| |
| |
· had prior injection for CTS (hand specific)
|
| |
· has amputation of second or third digits at MCP or PIP in either hand (censor for all CTS analyses)
|
| |
Right Censor if:
|
|
3. Time difference between + (positive) NCS and consecutive N/T followups must occur within 6-months)
|
· becomes CTS incident case (hand specific1)
|
|
4. Automatically a case if has surgery for CTS, provided the surgery cause is said to be “work-related” or “unsure”) and review by physician (KTH) suggests CTS.
|
· leaves the study permanently (non-case)
|
|
Lateral Epicondylalgia:
|
Exclude from Consideration if:
all exclusions are hand specific
1
|
|
Case if meets: (1 + 2 + 3) OR 4
| |
|
1) Lateral elbow pain on interview present for ≥ 25% of days since last follow-up (from monthly follow-up interview).
|
· met the case definition at baseline
|
| |
· had prior lateral elbow surgery
|
| |
· had prior elbow surgery of unknown type
|
|
2) “Pain” upon palpation of 1 or more of 6 lateral tender points (from monthly follow-up physical exam).
|
· had prior diagnosis of lateral epicondylalgia
|
| |
· had prior treatment for lateral epicondylalgia
|
|
3) Automatically a case if have surgery or injection for lateral epicondylalgia, provided the surgery cause is said to be “work-related” or “unsure”) and review by physician (KTH) suggests lateral epicondylalgia.
| |
| |
· had prior radial nerve pain
|
| |
Right Censor if:
|
| |
· becomes Lateral Epicondylalgia incident case (hand specific1)
|
| |
· suffers an elbow injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
Medial Epicondylalgia:
|
Exclude from Consideration if:
all exclusions are hand specific
1
|
|
Case if meets: (1 + 2 + 3) OR 4
| |
|
1) Medial elbow pain on interview present for ≥ 25% of days since last follow-up (from monthly follow-up interview).
|
· met the case definition at baseline
|
| |
· had prior medial elbow surgery
|
| |
· had prior elbow surgery of unknown type
|
|
2) “Pain” upon palpation of 1 or more of 2 medial tender points (from monthly follow-up physical exam).
|
· had prior ulnar neuropathy or cubital tunnel surgery, OR clinical impression of ulnar neuropathy.
|
|
3) Automatically a case if have surgery or injection for medial epi, provided the surgery cause is said to be “work-related” or “unsure” and review by physician (KTH) suggests medial epicondylalgia.
|
· had prior diagnosis of medial epicondylalgia
|
| |
· had prior treatment of medial epicondylalgia
|
| |
Right Censor if:
|
| |
· becomes medial epicondylalgia incident case (hand specific1)
|
| |
· suffers an elbow injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
deQuervain’s Tenosynovitis:
|
Exclude from Consideration if:
all exclusions are hand specific1
|
|
Case if meets: (1 + 2 + 3 + 4) OR 5
| |
|
1. Radial wrist pain for ≥ 25% of days since last follow-up (from monthly follow-up interview).
|
· met the case definition at baseline
|
| |
· had prior deQuervain’s surgery
|
| |
· had prior deQuervain’s treatment (injection)
|
|
2. 1st extensor compartment tenderness (from monthly follow-up physical exam).
| |
| |
· had prior deQuervain’s diagnosis
|
|
3. Positive Finkelstein test (active) (from monthly follow-up physical exam).
|
· has CMC/Wrist/MCP arthritis at baseline (or prior)
|
|
4. Automatically a case if have surgery or injection for deQuervain’s, provided the cause is said to be “work-related” or “unsure” and review by physician (KTH) suggests deQuervain’s.
|
Right Censor if:
|
| |
· becomes deQuervain’s incident case (hand specific1)
|
| |
· suffers a wrist injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· develops CMC/Wrist/MCP arthritis (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
Extensor Tendinosis (compartments 2-6)
|
Exclude from Consideration if:
all exclusions are hand specific
1
|
|
Case if meets: (1 + 2 + 3 + 4) OR 5
| |
|
1. Dorsal wrist pain for ≥ 25% of days since last follow-up.
|
· met the case definition at baseline
|
| |
· had prior wrist extensor tendinosis surgery
|
|
2. 2-6 extensor compartment tenderness.
| |
| |
· had prior wrist extensor tendinosis treatment (injection)
|
|
3. Positive resisted wrist extension
| |
| |
· had wrist arthritis at baseline (or prior)
|
|
4. Automatically a case if have surgery or injection for extensor tendinosis, provided the cause is said to be “work-related” or “unsure” and review by physician (KTH) suggests extensor tendinosis.
|
Right Censor if:
|
| |
· becomes wrist extensor tendinosis incident case (hand specific1)
|
| |
· suffers a wrist injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· develops wrist arthritis (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
Digital Flexor Tendinosis
|
Exclude from Consideration if:
all
|
|
Case if meets: (1 + 2 + 3 + 4) OR 5
|
exclusions are hand specific
1
|
|
1. Volar wrist pain – from Hand Pain Diagram
|
· met the case definition at baseline
|
| |
· had prior flexor tendinosis surgery
|
|
2. Digital flexor tendon tenderness (from monthly follow-up physical exam).
| |
| |
· had prior flexor tendinosis treatment (injection)
|
|
3. No numbness/tingling in digits 1-4 (from monthly follow-up interview).
| |
| |
· had wrist arthritis at baseline (or prior)
|
| |
Right Censor if:
|
|
4. Automatically a case if have surgery or injection for digital flexor tendinosis, provided the cause is said to be “work-related” or “unsure” and review by physician (KTH) suggests digital flexor tendinosis
| |
| |
· becomes flexor tendinosis incident case (hand specific1)
|
| |
· suffers a wrist injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· develops wrist arthritis (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
Trigger Finger/Trigger Thumb
|
Exclude from Consideration if:
all exclusions are hand specific
1
|
|
Case if meets: (1 + 3) OR (2 + 3) OR 4
| |
|
1. Pain in the finger (from both monthly follow-up physical exam and interview) AND Focal tenderness over A-1 pulley
|
· met the case definition at baseline
|
| |
· had prior trigger finger/thumb
|
| |
· had prior finger/hand surgery
|
|
2. Demonstrated triggering (from monthly follow-up physical exam OR monthly interview).
|
· had prior treatment for trigger finger/thumb (injection)
|
| |
· had MCP/finger OA at baseline
|
|
3. Automatically a case if have surgery or injection for trigger finger, provided the cause is said to be “work-related” or “unsure” and review by physician (KTH) suggests trigger finger.
|
Right Censor if:
|
| |
· becomes trigger finger/thumb incident case (hand specific1)
|
| |
· suffers a hand/finger injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
Non-Specific Pain
|
Exclude from Consideration if:
all exclusions are hand specific
1
|
|
Case if meets: (1 + 3) OR (2 + 3)
| |
|
1) Pain in DUE with intensity ≥ 6 for ≥ 25% of days since last follow-up that is NOT associated with a specific disorder.
|
· met the case definition for non-specific pain at baseline
|
| |
· met the case definition for any specific disorders at baseline
|
|
2) Pain in DUE of any intensity AND taking medication for pain.
| |
|
3)
|
a. Carpal Tunnel Syndrome
|
| |
b. Lateral Epicondylalgia
|
| |
c. Medial Epicondylalgia
|
| |
d. deQuervain’s
|
| |
e. Extensor Tendinosis
|
| |
f. Digital Flexor Tendinosis
|
| |
g. Trigger Finger/Trigger Thumb
|
| |
Right Censor if:
|
| |
· becomes a non-specific pain incident case (hand specific1)
|
| |
· becomes an incident case for ANY specific disorder
|
| |
a. Carpal Tunnel Syndrome
|
| |
b. Lateral Epicondylalgia
|
| |
c. Medial Epicondylalgia
|
| |
d. deQuervain’s
|
| |
e. Extensor Tendinosis
|
| |
f. Digital Flexor Tendinosis
|
| |
g. Trigger Finger/Trigger Thumb
|
| |
· suffers a DUE injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
|
Aggregate Disorders
|
Exclusions from Consideration:
|
|
Case if meets: 1
|
· Subjects are excluded from becoming a case under specific disorders based on the specific exclusion criteria above. Note: Subjects may still be eligible to become an aggregate disorder case despite being ineligible under certain disorders. (e.g. a subject that is excluded from becoming a case for trigger finger/trigger thumb, DeQuervain’s, and lateral and medial epicondylalgia, may still become a case for CTS, extensor, or digital flexor tendinosis, and is therefore still eligible to become a case for aggregate disorders.)
|
|
2. Meets any of the following case definitions as defined above:
| |
|
a. Carpal Tunnel Syndrome
| |
|
b. Lateral Epicondylalgia
| |
|
c. Medial Epicondylalgia
| |
|
d. deQuervain’s
| |
|
e. Extensor Tendinosis
| |
|
f. Digital Flexor Tendinosis
| |
|
g. Trigger Finger/Trigger Thumb
| |
|
Note: person level based on development of any of above disorders in either hand.
| |
| |
· If a subject is not eligible to become a case
|
| |
for any of the 7 specific disorders listed to the left, the subject is excluded from aggregate disorders
|
| |
Right Censor if:
|
| |
· becomes aggregate disorder incident case (hand specific1)
|
| |
· suffers a hand/wrist/elbow injury (i.e. accident, fall, etc..) (hand specific1, non-case)
|
| |
· permanently leaves the study (non-case)
|
