Lack of utility of Semmes-Weinstein monofilament testing in suspected carpal tunnel syndrome.
OBJECTIVE
To investigate the value of Semmes-Weinstein monofilament (SWM) testing in patients with electrodiagnostically confirmed carpal tunnel syndrome in a group of patients with symptoms compatible with carpal tunnel syndrome.


METHODS
A total of 119 consecutive patients with symptoms compatible with carpal tunnel syndrome were assessed. Blinded comparison of two Semmes-Weinstein monofilament testing protocols with orthodromic midpalm electrodiagnostic testing was performed. The electrodiagnostic test was considered the standard to which the results of the Semmes-Weinstein monofilament testing were measured.


RESULTS
Fifty three percent of our patients had electrodiagnostically confirmed carpal tunnel syndrome. Using a conservative Semmes-Weinstein monofilament testing protocol the sensitivity was 98% and the specificity was 15%. The positive predictive value was 56% and the negative predictive value was 88%. Using a liberal Semmes-Weinstein monofilament testing protocol the sensitivity was 13% and the specificity was 88%. The positive predictive value was 53% and the negative predictive value was 47%.


CONCLUSIONS
Semmes-Weinstein monofilament testing was not shown to have utility in diagnosing electrodiagnostically confirmed carpal tunnel syndrome in our population of predominantly male veterans.
Pagel
Keith J
KJ
Rehabilitation Medicine Service, Department of Veterans Affairs Medical Center, Portland, Oregon 97207, USA.
Kaul
Matthew P
MP
Dryden
John D
JD
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D003943:Diagnostic Techniques, Neurological / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity