Sensitivity and specificity of hand elevation test for carpal tunnel syndrome

Abstract

Problem : Is hand elevation test a good provocative test for the diagnosis of carpal tunnel syndrome (CTS)?

Objective : The aim of this study is to establish sensitivity and specificity value of hand elevation test for the diagnosis of CTS in comparison to Tinel’s test, modified Phalen’s test and carpal compression test.

Methods : Forty-eight patients presented with symptoms of CTS that have been recruited for nerve conduction study at King Chulalongkorn Memorial Hospital to confirm the diagnosis. All patients were clinically evaluated
using hand elevation test, Tinel’s test, modified Phalen’s test and carpal compression test. Electrodiagnosis studies were subsequently conducted to confirm the diagnosis of CTS. Sensitivity and specificity of each provocative test were determined.

Results : Sensitivity of hand elevation test, Tinel’s test, modified Phalen’s test and carpal compression test were 74.0%, 24.7%, 46.8% and 64.9%, respectively. Specificity of hand elevation test, Tinel’s test, modified Phalen’s test and carpal compression test were 52.6%, 89.5%, 57.9% and 73.7%, respectively. Sensitivity of hand elevation test combined with carpal compression test was 80.5% which was the highest combination test among others.

Conclusion : Hand elevation test had the highest sensitivity among other provocative test. Combination of hand elevation test with carpal compression test also had higher sensitivity than other combination tests in the diagnosis of CTS.