Forearm Flexor Tenosynovitis: Sensitivity and Specificity

Introduction: As a differential diagnosis for Carpal Tunnel Syndrome. Most physical exam tests actually pick up tenosynovitis much more sensitively/specifically than they do Carpal Tunnel (i.e. actual neuropathy). Thus, the exam will pick up irritation in the carpal tunnel that can be managed medically.

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The sensitivity and specificity of findings for Forearm Flexor Tenosynovitis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Carpal Tunnel Compression	95%	97%	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
Phalen's Test	92%	87%	complete palmer wrist flexion for 60 s Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Reverse Phalen's Test	75%	85%	complete dorsal wrist flexion for 60 s Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945
Tinel's Sign	46%	85%	percussion of the median nerve at the wrist Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945