Sensitivity and specificity of clinical testing for carpal tunnel syndrome.
OBJECTIVE
The present study evaluated the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of carpal tunnel syndrome (CTS).


METHODS
There were 29 carpal tunnel syndrome (CTS) subjects (mean age 48 years) and 30 control subjects (mean age 45 years). The six clinical tests included Tinel's sign, wrist flexion with fingers extended, wrist flexion with fingers flexed, wrist extension, combined wrist extension/median nerve pressure and combined wrist flexion/median nerve pressure.


RESULTS
The highest sensitivity and highest negative predictive value was found with wrist flexion with pressure (96%) and wrist extension with pressure (94%) at 60 s. The highest specificity was found with wrist flexion with fingers flexed for 30 s (95%). The highest positive predictive values were found with the wrist flexion with fingers flexed test for 30 s (91%) and the wrist extension test for 30 s (90%).


CONCLUSIONS
No one test possesses all the qualities necessary to be the ideal clinical test for the detection of carpal tunnel syndrome.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Irvin M
IM
Wiesman
Christine B
CB
Novak
Susan E
SE
Mackinnon
Jonathan M
JM
Winograd
Carpal tunnel syndrome; Evaluation