Forearm Flexor Tenosynovitis: Likelihood Ratios

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 likelihood ratios of findings for Forearm Flexor Tenosynovitis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Carpal Tunnel Compression	31.7	0.1	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	7.1	0.1	complete palmer wrist flexion for 60 s Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945
Reverse Phalen's Test	5	0.3	complete dorsal wrist flexion for 60 s Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945

Good Positive Likelihood Ratio

Finding	+LR	-LR	Comments, Study
Tinel's Sign	3.1	0.6	percussion of the median nerve at the wrist Study: Joint Bone Spine. 2008 Jul;75(4):451-7. PMID: 18455945