Carpal tunnel syndrome diagnostic study of choice: Difference between revisions

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== Overview ==
== Overview ==
CTSs Symptoms include numbness, pain, or paresthesia in the median nerve distribution.
Commonly used provocative tests include wrist flexion (Phalen), nerve percussion (Tinel), and carpal compression (Durkan) tests.
Electrodiagnostic studies (EDS) and imaging evaluations are used in order to confirm diagnosis.


== Diagnosis ==
== Diagnosis ==
==== Diagnostic Value of History and Physical Examination Findings for Carpal Tunnel Syndrome ====
{| class="wikitable"
! colspan="1" rowspan="1" |FINDING
! colspan="1" rowspan="1" |SENSITIVITY (%)
! colspan="1" rowspan="1" |SPECIFICITY (%)
|-
| colspan="1" rowspan="1" |Flick sign
| colspan="1" rowspan="1" |93
| colspan="1" rowspan="1" |96
|-
| colspan="1" rowspan="1" |Hypalgesia
| colspan="1" rowspan="1" |39
| colspan="1" rowspan="1" |88
|-
| colspan="1" rowspan="1" |Square wrist sign
| colspan="1" rowspan="1" |53
| colspan="1" rowspan="1" |80
|-
| colspan="1" rowspan="1" |Classic or probable pattern on hand symptom diagram
| colspan="1" rowspan="1" |64
| colspan="1" rowspan="1" |73
|-
| colspan="1" rowspan="1" |Abduction weakness
| colspan="1" rowspan="1" |65
| colspan="1" rowspan="1" |65
|-
| colspan="1" rowspan="1" |Thenar atrophy
| colspan="1" rowspan="1" |16
| colspan="1" rowspan="1" |90
|-
| colspan="1" rowspan="1" |Tinel sign
| colspan="1" rowspan="1" |36
| colspan="1" rowspan="1" |75
|-
| colspan="1" rowspan="1" |Phalen maneuver
| colspan="1" rowspan="1" |57
| colspan="1" rowspan="1" |58
|-
| colspan="1" rowspan="1" |Nighttime or morning symptoms
| colspan="1" rowspan="1" |70
| colspan="1" rowspan="1" |43
|-
|Electrodiagnostic
|49–84
|95–99
|-
|Ultrasonography
|82
|92
|-
|MRI
|63-83
|78-80
|-
|Computed tomograph
|67
|87
|}


== References ==
== References ==

Revision as of 19:56, 18 May 2018

Overview

CTSs Symptoms include numbness, pain, or paresthesia in the median nerve distribution.

Commonly used provocative tests include wrist flexion (Phalen), nerve percussion (Tinel), and carpal compression (Durkan) tests.

Electrodiagnostic studies (EDS) and imaging evaluations are used in order to confirm diagnosis.

Diagnosis

Diagnostic Value of History and Physical Examination Findings for Carpal Tunnel Syndrome

FINDING SENSITIVITY (%) SPECIFICITY (%)
Flick sign 93 96
Hypalgesia 39 88
Square wrist sign 53 80
Classic or probable pattern on hand symptom diagram 64 73
Abduction weakness 65 65
Thenar atrophy 16 90
Tinel sign 36 75
Phalen maneuver 57 58
Nighttime or morning symptoms 70 43
Electrodiagnostic 49–84 95–99
Ultrasonography 82 92
MRI 63-83 78-80
Computed tomograph 67 87

References

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