The diagnostic assessment of hand elevation test in carpal tunnel syndrome

• Published in: Journal of Korean Neurosurgical Society Vol. 52; no. 5; pp. 472 - 475
• Main Authors: Ma, Hyunjin, Kim, Insoo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Neurosurgical Society 01.11.2012; 대한신경외과학회
• Subjects: Clinical; 신경외과학; Tinel's test; Carpal compression test; Carpal tunnel syndrome; Phalen's test; Hand elevation test
• ISSN: 2005-3711; 1598-7876
• DOI: 10.3340/jkns.2012.52.5.472

The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand elevation test as provocative tests for CTS. We used chi-square analysis to compare Tinel's test and Phalen's test, carpal compression test with hand elevation test. The sensitivity and specificity of the hand elevation test is 86.7% and 88.9% each. Tinel's test had 82.2% sensitivity and 88.9% specificity. Phalen's test had 84.4% sensitivity and 86.7% specificity. Carpal compression test had 84.4% sensitivity 82.2% specificity. Comparisons of sensitivity and specificity between hand elevation test and Tinel's test, Phalen's test, and carpal compression test had no statistically significant differences. To compare the diagnostic accuracies of four tests, the area under the non-parametric receiver operating character curve was applied. The hand elevation test has higher sensitivity and specificity than Tinel's test, Phalen's test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective campared with Tinel's test, Phalen's test, and carpal compression test.