Disease criteria for case | Exclusions & Right Censor Conditions |
---|---|
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) |