Carpal tunnel syndrome. Evaluation of a quantitative provocational diagnostic test

Clin Orthop Relat Res. 1990 Feb:(251):157-61.

Abstract

A diagnostic test combining the sensitivity of the Semmes-Weinstein monofilament measurement and the specificity of the wrist flexion provocational test has been evaluated in a group of 21 patients (33 hands) with electrodiagnostically verified carpal tunnel syndrome and 30 asymptomatic hands (controls). Semmes-Weinstein monofilament testing consisted of several sensory threshold measurements obtained by the application of force-calibrated Semmes-Weinstein monofilaments to each digit in the hand with the wrist in neutral position. The quantitative provocational diagnostic test employed Semmes-Weinstein measurements obtained with the wrist both in the neutral and flexed positions. The sensitivity (82%) and specificity (86%) of the combined test were calculated. It was more sensitive and specific than the wrist flexion test alone and more specific than the Semmes-Weinstein sensibility test. The combined test is recommended as the most accurate and sensitive quantitative clinical test for median nerve compression evaluated by the authors to date.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / diagnosis*
  • Carpal Tunnel Syndrome / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Movement
  • Physical Examination / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Sensory Thresholds
  • Wrist Joint / physiopathology