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Research article

First published June 2003

Sensitivity and specificity of clinical testing for carpal tunnel syndrome

Irvin M Wiesman, Md, Christine B Novak, Pt Ms, […], Susan E Mackinnon, Md Dr [email protected], and Jonathan M Winograd, Md+1View all authors and affiliations

Volume 11, Issue 2

https://doi.org/10.1177/229255030301100205

Abstract

Abstract

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%).

Conclusion

No one test possesses all the qualities necessary to be the ideal clinical test for the detection of carpal tunnel syndrome.

Résumé

Objectif

La présente étude a évalué la sensibilité, la spécificité et les valeurs prédictives de six épreuves cliniques dans le diagnostic du syndrome du canal carpien.

Méthodologie

Il y avait 29 sujets atteints du syndrome du canal carpien (SCC) (âge moyen de 48 ans) et 30 sujets témoins (âge moyen de 45 ans). Les six épreuves cliniques incluaient le signe de Tinel, la flexion du poignet les doigts dépliés, la flexion du poignet les doigts fléchis, l'extension du poignet, l'extension du poignet combinée à la pression du nerf médian et la flexion du poignet combinée à la pression du nerf médian.

RÉSULTATS

La sensibilité la plus élevée et la valeur prédictive la plus négative ont été découvertes au moyen de la flexion du poignet avec pression (96 %) et de l'extension du poignet avec pression (94 %) pendant 60 s. La spécificité la plus élevée a été établie avec la flexion du poignet les doigts fléchis pendant 30 s (95 %) et avec l'épreuve d'extension du poignet pendant 30 s (90 %).

Conclusion

Aucune épreuve ne possède toutes les qualités nécessaires pour constituer l'épreuve clinique idéale permettant de déceler le syndrome du canal carpien.

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