19 Del. Admin. Code § 1342-C-3.0
Cumulative Trauma Disorders (CTDs) of the upper extremity comprise a heterogeneous group of diagnoses which include numerous specific clinical entities, including disorders of the muscles, tendons and tendon sheaths, nerve entrapment syndromes, joint disorders, and neurovascular disorders.
The terms "cumulative trauma disorder", "repetitive motion syndrome", "repetitive strain injury" and other similar nomenclatures are umbrella terms that are not acceptable diagnoses. The health care provider must provide specific diagnoses in order to appropriately educate, evaluate, and treat the patient. Examples include DeQuervain's tendonitis, cubital tunnel syndrome, lateral/medial epicondylitis, olecranon bursitis, and hand-arm vibration syndrome. Many patients present with more than one diagnosis, which requires thorough upper extremity and cervical evaluation by the health care provider. Furthermore, there must be a causal relationship between work activities and the diagnosis (see Initial Diagnostic Procedures). The mere presence of a diagnosis that may be associated with cumulative trauma does not presume work-relatedness unless the appropriate work exposure is present.
Mechanisms of injury for the development of CTDs remain controversial. Posture, repetition, force, vibration, cold exposure, and combinations thereof are postulated and generally accepted as risk factors for the development of CTDs. Evaluation of a CTD requires an integrated approach that incorporates ergonomics, clinical assessment, and psychosocial evaluation on a case-by-case basis.
19 Del. Admin. Code § 1342-C-3.0