Clinical assessment of suspected damage from hand-held vibrating tools. 1987

L Ekenvall
Clinic of Occupational Medicine, Karolinska sjukhuset, Stockholm, Sweden.

The case history is still the cornerstone in the clinical assessment of suspected vibration injury. Objective tests to verify the symptoms are needed for legal reasons in insurance cases and for research purposes. The minimum requirement of a test used to obtain objective signs of Raynaud's phenomenon is that patients with vibration-induced white finger be evaluated along with symptom-free, but vibration-exposed, subjects for reference. The measurement of systolic blood pressure in the finger after local finger and general body cooling is a test that has been evaluated in this way, as has restitution of finger temperature after local cooling and ischemia combined with general body heating. If neurological symptoms are present, electroneurographic examination is essential since carpal tunnel syndrome, a treatable condition, is common in vibration-exposed patients. Measurements of vibration and temperature thresholds are complementary examinations. The so-called vibrogram may be a method with which to obtain objective neurological signs of vibration injury, but the test needs further evaluation. Until more is known of the pathophysiological mechanisms behind the disease, the patient's description of his symptoms, combined with a detailed exposure history, will remain essential for a diagnosis of vibration injury--irrespective of the results of the tests used.

UI MeSH Term Description Entries
D009784 Occupational Diseases Diseases caused by factors involved in one's employment. Diseases, Occupational,Occupational Illnesses,Disease, Occupational,Illnesse, Occupational,Illnesses, Occupational,Occupational Disease,Occupational Illnesse
D011928 Raynaud Disease An idiopathic vascular disorder characterized by bilateral Raynaud phenomenon, the abrupt onset of digital paleness or CYANOSIS in response to cold exposure or stress. Cold Fingers, Hereditary,Raynaud Phenomenon,Raynaud's Disease,Raynauds Disease
D002349 Carpal Tunnel Syndrome Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45) Compression Neuropathy, Carpal Tunnel,Entrapment Neuropathy, Carpal Tunnel,Amyotrophy, Thenar, Of Carpal Origin,Median Neuropathy, Carpal Tunnel,Carpal Tunnel Syndromes,Syndrome, Carpal Tunnel,Syndromes, Carpal Tunnel
D003080 Cold Temperature An absence of warmth or heat or a temperature notably below an accustomed norm. Cold,Cold Temperatures,Temperature, Cold,Temperatures, Cold
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D006225 Hand The distal part of the arm beyond the wrist in humans and primates, that includes the palm, fingers, and thumb. Hands
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014732 Vibration A continuing periodic change in displacement with respect to a fixed reference. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Vibrations

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