Clinical diagnosis of carpal tunnel syndrome: Old tests–new concepts

Yasser El Miedany, Samia Ashour Sally Youssef, Annie Mehanna and Fatma A. Meky

The aim of this study was to examine the relationship between the clinical manifestations of CTS with the outcome of the diagnostic tools (nerve conduction tests and ultrasonography), and its implication for clinical practice. All patients and controls completed a patient oriented questionnaire, were subjected to clinical testing for provocative tests for carpal tunnel syndrome (Tinel’s, Phalen’s, Reverse Phalen’s and carpal tunnel compression tests), nerve conduction testing as well ultrasonographic assessment of the carpal tunnel and median nerve. The results of this study revealed that Tinel’s, Phalen’s, Reverse Phalen’s and carpal tunnel compression tests are more sensitive, as well as being specific tests for the diagnosis of tenosynovitis of the flexor muscles of the hand, rather than being specific tests for carpal tunnel syndrome and can be used as an indicator for medical management of the condition.

Joint Bone Spine, June 2008, article in press

doi:10.1016/j.jbspin.2007.09.014

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Filed under: Assessment, Wrist

Acute Carpal Tunnel Syndrome

Kent A. Schnetzler, MD

Carpal tunnel syndrome is considered the most common of the chronic compressive neuropathies. Its cause is generally unknown. Acute carpal tunnel syndrome, which is much less common, is more often directly related to fractures and fracture-dislocations about the wrist, hemorrhagic conditions, and vascular disorders involving the wrist. Many rare and unusual causes have been described, including chronic conditions that may be associated with acute carpal tunnel syndrome, such as rheumatologic disorders and anomalous anatomy. In contrast to the more common chronic idiopathic form, the acute form of carpal tunnel syndrome requires urgent surgical intervention to avoid or diminish serious sequelae.

Journal of the American Academy of Orthopaedic Surgeons, May 2008, 276-282.

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Filed under: Neurological, Wrist