Please select the eligibility criteria that correspond to the clinical trial below.
Title: Carpal Tunnel Syndrome: Diagnosis and Treatment Trial
Brief Summary: The Carpal Tunnel Syndrome Diagnosis and Treatment Trial is project #1 of the Multidisciplinary Clinical Research Center focused on upper extremity pain. It is a randomized trial comparing surgical and nonsurgical treatments for patients with early, mild to moderate carpal tunnel syndrome. In addition the study will evaluate the ability of a new magnetic resonance (MR) technique at predicting who will likely benefit from carpal tunnel syndrome (CTS) surgery.


Options:
A: Inclusion Criteria:

* pain and paresthesia in the median nerve distribution without extra-median nerve territory symptoms;
* increasing symptoms during night;
* Tinel sign;
* Phalen sign;
* self-reported hand strength deficits.
* Deficits of sensory and motor nerve conduction of the median nerve according to standardized guidelines of the American Association of Electrodiagnosis, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation

Exclusion Criteria:

* if any sensory/motor deficit in ulnar or radial nerve was present;
* previous interventions with surgery or steroid injections;
* multiple diagnoses of the upper extremity (i.e., cervical radiculopathy, lateral epicondylalgia);
* history of neck, shoulder or arm trauma;
* history of a systemic disease causing CTS (e.g. diabetes mellitus, or thyroid disease);
* history of systemic musculoskeletal conditions (e.g. rheumatoid arthritis, fibromyalgia);
* if the patient was actively involved with or seeking litigation at the time of the study;
* pregnancy.
B: Inclusion Criteria:

* Primary idiopathic CTS
* Symptoms of classic or probable CTS according to the Katz diagnostic criteria (numbness and/or tingling in at least 2 of the 4 median nerve innervated fingers)
* Failed treatment with wrist splinting (2 months)
* Nerve conduction tests showing median neuropathy at the wrist or, if normal, two orthopedic surgeons independently make CTS diagnosis
* Symptom severity that warranted referral for consideration for surgery

Exclusion Criteria:

* Previous steroid injection for CTS
* Thenar muscle atrophy
* Sensory deficit (two-point discrimination \>8 mm)
* Diabetes, thyroid disorder, or inflammatory disease
* Polyneuropathy or vibration-induced neuropathy
* Current pregnancy
* Previous carpal tunnel surgery on the study hand
* Surgery on the contralateral hand in the past 2 months
* Inability to respond to questionnaires
* Severe medical illness
* Known drug/alcohol abuse
C: Inclusion Criteria:

* Pain and paresthesia in the median nerve distribution
* Positive Tinel sign,
* Positive Phalen sign,
* Symptoms had to have persisted for at least 6 months
* Deficits of sensory and motor median nerve conduction according to guidelines of the American Association of Electrodiagnosis, American Academy of Neurology, and the American Physical Medicine and Rehabilitation Academy

Exclusion Criteria:

* Any sensory/motor deficit related to the ulnar or radial nerve;
* Older than 65 years of age;
* Previous surgical intervention, steroid injections or physical therapy intervention
* Multiple diagnoses of the upper extremity (eg, cervical radiculopathy);
* History of neck, shoulder, or upper limb trauma (whiplash);
* History of any systemic disease causing CTS (eg, diabetes mellitus or thyroid disease);
* History of other systemic conditions (eg, rheumatoid arthritis, fibromyalgia);
* Pregnancy
D: Inclusion Criteria:

* Paresthesias involving 2 digits on hand diagram
* Willingness and ability to complete interviews

Exclusion Criteria:

* Evidence of denervation on EDS
* Abnormal 2-pt discrimination or thenar atrophy
* Prior wrist surgery or acute external trauma
* MRI contraindications
* Metallic hardware in wrists

Answer: D