Lack of predictive power of the "tethered" median stress test in suspected carpal tunnel syndrome.
OBJECTIVE
To investigate the value of the "tethered" median nerve stress test (TMST) in predicting electrodiagnostically confirmed carpal tunnel syndrome (CTS) in patients with symptoms suggestive of CTS.


METHODS
Blinded comparison of a clinical diagnostic test with neurophysiologic testing.


METHODS
Portland (OR) Veterans Administration Medical Center Electrodiagnostic Laboratory.


METHODS
One hundred two consecutive patients referred for symptoms suggestive of CTS. Study inclusion criteria were referral for evaluation of symptoms of paresthesia (with or without pain) inclusive of the median nerve distribution distal to the wrist.


RESULTS
Fifty-seven percent of referred patients had electrodiagnostically confirmed CTS. The sensitivity of the TMST was 50%. The specificity was 59.1%. The positive predictive value was 61.7%. The negative predictive value was 47.3%.


CONCLUSIONS
The TMST does not have utility in predicting electrodiagnostic consult results in veteran patients with symptoms suggestive of CTS.
Kaul
M P
MP
The Department of Physical Medicine and Rehabilitation, Portland Veterans Administration Medical Center, OR, USA.
Pagel
K J
KJ
Dryden
J D
JD
D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity