Diagnosis
In order to determine whether Carpal Tunnel Syndrome is present, one must first evaluate the wrist. There are a few orthopedic tests that are able to determine the presence of CTS. The following are some examples to consider utilizing during the evaluation process.
Orthopedic Tests
![Picture](/uploads/2/8/6/8/28685697/5385091.jpg?293)
Phalen Test (Wrist Flexion Test)
- Sensitivity=34%-93%
- Specificity=48%-93%
- Procedure: patient places dorsal surfaces of hands together with wrists flexed for 1 minute
- Positive Sign: numbness or tingling in the thumb, index finger, middle finger, and/or lateral half of ring finger
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![Picture](/uploads/2/8/6/8/28685697/6579688.jpeg)
Reverse Phalen’s Test
- Sensitivity=88%
- Specificity=93%
- Procedure: patient places elbows on table with hands up and wrists flexed for 1 minute
- Positive Sign: numbness or tingling in the thumb, index finger, middle finger, and/or lateral half of ring finger
![Picture](/uploads/2/8/6/8/28685697/9863550.jpg)
Tinel’s Sign
- Sensitivity=27%-79%
- Specificity=65%-98%
- Procedure: AT taps volar surface of wrist (over carpal tunnel)
- Positive Sign: tapping causes paresthesia in the thumb, index finger, middle finger, and/or lateral half of ring finger; tingling is distal to tapping location
Wrist Flexion & Median Nerve Compression Test
- Sensitivity=61%
- Specificity=83%
- Procedure: AT extends the patient’s elbow, supinates forearm, flexes wrist to 60⁰ then applies pressure with thumb over the median nerve at the wrist, holding for 20 seconds.
- Positive Sign: pain and paresthesia in the thumb, index finger, middle finger, and/or lateral half of ring finger
Flick Maneuver
- Sensitivity=37%
- Specificity=74%
- Procedure: with hands relaxed, patient shakes hands vigorously repeatedly
- Positive Sign: numbness or tingling in the thumb, index finger, middle finger, and/or lateral half of ring finger