Standardized diagnostic practice and analysis of occupational carpal tunnel syndrome
10.20001/j.issn.2095-2619.20260414
- VernacularTitle:职业性腕管综合征规范化诊断实践与探索
- Author:
Xiaoyi LI
1
;
Li HUANG
;
Xiao ZHANG
;
Junle WU
;
Kankan DENG
;
Bin XIAO
;
Lihua XIA
Author Information
1. Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong 510300, China
- Publication Type:Journal Article
- Keywords:
Carpal tunnel syndrome;
Standardization;
Occupational disease diagnosis;
Occupational exposure history;
High-frequency color Doppler ultrasonography;
Nerve conduction studies and electromyography;
Clinical symptoms;
on-site occupational health investigation
- From:
China Occupational Medicine
2026;53(2):201-206
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the core elements of standardized diagnosis of occupational carpal tunnel syndrome (OCTS). Methods Data of first reported OCTS case in Guangdong Province were retrospectively analyzed, including occupational exposure history, clinical manifestations, auxiliary examinations, and on-site occupational health investigation results. Furthermore, standardized diagnostic approaches for such occupational diseases were explored. Results The patient worked in a garment manufacturing enterprise, engaged in fabric cutting. The patient had a occupational history of at least three consecutive years of repetitive right wrist work, holding a 15.2 kg electric cutting tool for a cumulative 6.6 hours per day, with awkward wrist movements repeated 13 times per minute. Clinical symptoms included numbness and reduced muscle strength in the areas of median nerve distribution of the right hand, which were aggravated during work and relieved after rest. Physical examination showed inability of right hand to perform fine motor opposition movements of the thumb with the index, middle, and ring fingers; decreased tactile, pain, vibration, graphesthesia, and kinesthetic sensations below the right wrist; and positive Tinel′s sign over the median nerve at the wrist crease level, Phalen′s test, and reverse Phalen′s test of right wrist. Both wrist high-frequency color Doppler ultrasonography and nerve conduction studies and electromyography indicated damage to the right median nerve. However, only the findings from high-frequency color Doppler ultrasonography of the wrist meet the diagnostic criteria specified in GBZ 336-2025 Diagnostic Standard for Occupational Carpal Tunnel Syndrome. On-site occupational health investigation confirmed that the work involved typical repetitive wrist work, and three co-workers in similar positions exhibited comparable symptoms. The case was ultimately diagnosed as OCTS. Conclusion The definitive diagnosis of OCTS requires comprehensive evaluation of four core elements: a clear occupational exposure history, typical clinical symptoms and signs, characteristic objective examination findings, and quantitative on-site occupational health investigation data. Only when these four elements corroborate each other and non-occupational causative factors are excluded can a definitive diagnosis be made.
