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signs. or complexes of symptoms and signs. The “diagnoses** of the screening method used in the present study are an example of the last-mentioned type.

Some evidence has been found which indicates the predictive value of ccrtam symptoms and signs. Riihimaki et al (13) found that current neek pain better pre-dieted the experiencing of neck pain aftcr five years had passed than did findings of degeneration in cervical radiographs. Tenderness upon palpation of the brachial plexus was predietive of neck pain five years later at a statisticalty significanl level. Nothing is known about the pre-diclive value of the symptom comp!excs of the screening method used in the present study. as no follow-up studies using this rnethod have been published.

The screening method used in this study is time-consuming and hard for both the subject and the examiner. espeeially when examinations are performed individually for. each worker. Both this study and another unpublished study by the author rarely found objective signs without subjective symptoms. Consequently it could be thought that only persons with subjective symptoms should be chosen for physica) examination.

In middle-age and older study groups degencrative changes cause symptoms and signs that cannot be singled out in a physical examination. Thus the method would probably be morę valuable when relatively young populations are screened.

Acknowledgment

I am grateful to Ms R Kukkonen for her part in the examination procedurę.

References

1.    Aguayo A. Neuropathy due to compression and entrapment. In: Dyck PJ. Thomas PK. Lambert EH. ed. Peripheral neuropathy. Volume I. WB Saunders Company. Phila-delphia. London.Toronto 1975. pp 688-713.

2.    Armstrong TJ. Chaffin DB. Car pa I lunncl syndrome and selected personal attribules. J occup med 21 (1979) 481-486.

3.    Cyriax J. Textbook of orihopoedic medi-cine. Volume 1 (Diagnosis of soft lissue lesions). Bailliere Tindall. London 1978.

pp 220- 221.

4.    Hagert CC. Lundborg C. Hansen T. Entrapment of the posterior inlerosseous nerve. Scand j piast reconśtr surg 11 (1977) 205-212.

5.    Jonsson B. Ericson B-E. Hagberg M.

Hedberg G. Ouchterlony-Jonsson E. Besvar frśn rórelseorganen inom olika branschcr:    Prcliminar rap port Arbelar-

skyddsstyrelscn.    Arbeisfysiologiska

enheten i Umoa. UmeJ 1981.

6.    Kuorinka l. Koskincn P. Occupational rheumatic diseases and upper limb sirain in manuał jobs in a light mcchanical induslry. Scand j work environ health 5 (1979): suppl 3. 39-47.

7.    Kurp pa K. Waris P. Rokkanen P. Peri-tendinitis and tcnosynovitis. Scand j work environ health 5(19791: suppl 3. 19-24.

8.    Luopajarvi T. Kuorinka 1. Virolainen M. Holmberg M. Prevalcnoe of ienosvnovitis and other injuries of the upper extremilies in repetitive work. Scand j work environ health 5 (1979): suppl 3. 48-55.

9.    Magnusson M. Ortengren R. Andersson G. Petersen I. Sabel B. Ergonomisk under-sókning av arbeismoment och besvars-fórekomsl i slyckningsarbete: Pilot sl ud ic*. Kapporl om etl LO-projeki tUl arbetar-skyddsfonden. Góteborg 1981.

10.    Moberg E. Debat! om domnande fingrar illustrerar bristen pi vardagsnvilig kunskap. Lakarlidningen 78(1981) 1064.

11.. Morris HH. Peters BH. Pronator syndrome: Clinical and electrophysiological features in sevcn cases. J neurol neurosurg psychiatry 39 (1976) 461-464.

12.    Phalen GS. The carpal-tunnel syndrome. Clin orthop 83(1972) 29 - 40.

13.    Riihimaki H. Hannincn K. Luopajarvi T. MattsonT. Waris P. WickstrómC. Zitting A. Raudoittaja- ja maalaritutkimus: Osa G. Raudoitiajien ' tuki- ja liikuntaelimistón tilan 5 vuoden seuranta. Institute of Occupational Health. Helsinki 1981. (Ty6lerveyslaitokscn tutkimuksia 172).

14.    Roos DB. New concepts in the etiology. diagnosis and surgical treatment of thoracic outlet syndrome. In: Greep JM. Ummens HAJ. Roos DB. Urschel HC. ed. Pain in shoulder and arm. Martinus Nijhoff Publtshers. Hague. Boston. London 1979. pp 201-210.

15.    Spinner M. Injuries to the major branches of peripheral nerve$ of the forearm.' WB Saunders Company. Philadelphia. London. Toronto 1978. pp 98- 132.

16.    Spinner M. Injuries to the major branches of peripheria! nerves of the forearm. WB Saunders Company. Philadelphia. London. Toronto 1978. pp 192-198.

17.    Vaaranen V. Vasama M. Occupational diseases in Finland in 1978-1979. Institute of Occupational Health. Helsinki 1980. (Revicws 5).

18.    Waris P. Kuorinka I. Kurppa K. Luop3jarvi T. Virolainen M. Pesonen K. Nummi J. Kukkonen R. Epidemiologie screening of occupational neck and upper limb disorders. Scand j work cnviron health 5 (1979): suppl 3. 25-38.

19.    Werner C-O. La terał elbow pain and posterior inlerosseous nervc entrapment. Acta orthop scand suppl 174 (1979) G2 p.

Received for publicalion: 16 Seplember 1982

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