Carpal tunnel syndrome diagnostic study of choice
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 |