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Pressure bandaging of the lower leg prior to minor surgery.

EMG and NCV tests can have a significant false-negative rate. In an era of HMOs and managed care, nonclinicians seeking to apportion medical resources are quick to embrace easily interpreted tests over the judgment of us, their clinical colleagues. A diagnosis of surgically correctable entrapment neuropathy can be made through clinical examination alone. As noted by Dr. Wise, we should avoid ordering tests merely to satisfy industrial or insurance company criteria. In clear-cut cases, electromyograph and nerve conduction velocity tests are unnecessary and add to the cost of care. We must continually try to educate case managers and insurance company administrators that over-reliance on electrodiagnostic testing can lead to false economy and poor patient care and that such testing should be eschewed in favor of astute clinical evaluation. Daniel Greenwald, M.D. Division of Plastic Surgery University of South Florida 505 South Boulevard Tampa, Fla. 33606