Carpal Tunnel Syndrome: Sensitivity and Specificity

Introduction: Actual median nerve neuropathy. See also Forearm Flexor Tenosynovitis - most physical exam findings for Carpal Tunnel Syndrome actually pick up Tenosynovitis in the carpal tunnel (i.e. from flexor tendonitis) far better than they do 'Carpal Tunnel' (i.e. median neuropathy). Tendonitis should be managed medically, while neuropathy would be treated by surgical decompression.

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The sensitivity and specificity of findings for Carpal Tunnel Syndrome are listed below. See the left navigation bar to change the display.

Negative Findings

Finding	Sensitivity	Specificity	Comments, Study
Tinel's Sign	30%	65%	percussion of the median nerve at the wrist Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945
Reverse Phalen's Test	42%	35%	complete dorsal wrist flexion for 60 s Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945
Carpal Tunnel Compression	46%	25%	even pressure exerted by the examiner on the space between thenar and hypothenar eminence for 30 s while arm is supinated. The patient was questioned with regard to symptoms at 15-s intervals during the 30-s period Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945
Durkan's Test	71%	22%	Study: Dafang Zhang, Cassandra M. Chruscielski, Philip Blazar, Brandon E. Earp, Accuracy of Provocative Tests for Carpal Tunnel Syndrome, Journal of Hand Surgery Global Online, Volume 2, Issue 3, 2020, Pages 121-125, ISSN 2589-5141, https://doi.org/10.1016/j.jhsg.2020.03.002. (https://www.sciencedirect.com/science/article/pii/S2589514120300189)
Phalen's Test	47%	17%	complete palmer wrist flexion for 60 s Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945