Value of Gilliatt's pneumatic tourniquet test for diagnosis of carpal tunnel syndrome.
OBJECTIVE
In 1953, Gilliatt and Wilson described the pneumatic-tourniquet test to diagnose the carpal tunnel syndrome (CTS). It was originally carried out by inflating a brachial cuff at suprasystolic pressure, looking for the appearance of dysesthesiae; several authors later proposed to perform it at infrasystolic pressure, arguing that it would better reflect the elevated venous pressure supposed to be present in CTS. The purpose of this study was to compare both methods.


METHODS
This prospective randomized controlled study included 49 patients and compared both methods to perform Gilliatt's test with more commonly used provocative tests (Tinel, Phalen, Durkan, and Weber). The following end-points were considered: typical clinical presentation, altered neurophysiological tests, abnormal ultrasound findings and early resolution of symptoms after surgical decompression.


RESULTS
For all these end-points, no significant difference was observed in sensibility nor specificity, whether Gilliatt's test was performed supra- or infra-systolic. In addition, Gilliatt's test proved to have less diagnostic value than Phalen and Durkan tests for sensibility.


CONCLUSIONS
This study did not permit to distinguish the two versions of Gilliatt's test but to open a discussion about the utility of such a test to diagnose the CTS.
Department of Orthopaedics and Traumatology, Université Libre de Bruxelles, Erasme university hospital, 808, route de Lennik, 1070 Bruxelles, Belgium. tthungen@ulb.ac.be
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Thüngen
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Sadowski
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El Kazzi
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Schuind
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D014111:Tourniquets