Mr. Muiris Kennedy · Upper Limb Surgery

Patient
Questionnaires

Validated outcome measures to help assess your symptoms and track your progress. Please complete the relevant questionnaire before your consultation.

The Boston Carpal Tunnel Questionnaire (BCTQ) is a validated patient-reported outcome measure for carpal tunnel syndrome. It has two parts: the Symptom Severity Scale (SSS) and the Functional Status Scale (FSS). Please answer all questions based on how you have felt over the past two weeks.

Affected hand:
Progress 0 / 19 answered
Part 1 — Symptom Severity Scale
Questions 1 – 11 · Rate your symptoms over the past two weeks
Part 2 — Functional Status Scale
Questions 12 – 19 · Rate your difficulty performing daily activities

Please answer all 19 questions before calculating your scores.

Your Results
Scores range from 1 (no symptoms) to 5 (severe)
Symptom Severity Scale
SSS Score
/5
Functional Status Scale
FSS Score
/5
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Please bring these results to your consultation. A score of 1 indicates no symptoms or difficulty; a score of 5 indicates the most severe symptoms or complete inability to perform activities. These scores help Mr. Kennedy assess the severity of your condition and monitor your progress over time.

Answer three quick questions to help Mr. Kennedy understand your shoulder symptoms before your consultation. Your answers will indicate the most likely cause of your pain.

Progress 0 / 3 answered
Question 1 — Your Age
Helps identify the most likely shoulder conditions for your age group
Question 2 — Injury History
Distinguishes traumatic injury from gradual onset
Did you suffer a traumatic injury to your shoulder just before your symptoms started?
Question 3 — Location of Pain
Tap the area on the diagram that best matches where you normally feel your pain
Tap a zone to select it
Shoulder anatomy diagram 1 2 3 4
Zone 1 — Neck & trapezius
Zone 2 — Top of shoulder / AC joint
Zone 3 — Outer shoulder / deltoid
Zone 4 — Upper & lower arm (referred pain)

Please answer all 3 questions before continuing.

Likely Diagnosis
Based on your age, injury history and pain location
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Most likely cause
Age group
Traumatic injury
Pain location
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This is a clinical aid, not a diagnosis. Mr. Kennedy will examine you thoroughly at your consultation. Please bring this result with you — it helps him prepare for your appointment.