THE DIAGNOSIS OF CARPAL-TUNNEL SYNDROME - SENSITIVITY AND SPECIFICITYOF SOME CLINICAL AND ELECTROPHYSIOLOGICAL TESTS

The study group consisted of 100 persons referred with suspected carpa l tunnel syndrome. Clinical and neurophysiological examinations were p erformed blinded from each other. The gold standard for the carpal tun nel syndrome (CTS) diagnosis was based on the results of these examina tions but relief of CTS symptoms after surgery was also required. The sensitivity and specificity for the combined results of the clinical e xaminations were 94% and 80% respectively, and for the neurophysiologi cal examinations, 85% and 87%. Of the neurophysiological methods used, the quotient of sensory nerve conduction velocity between palm to wri st and wrist to elbow was best and the cut-off for this test was studi ed by means of an ROC-curve. According to our results clinical examina tion by an experienced doctor seems to be sufficient if there are typi cal symptoms of carpal tunnel syndrome, but if there is a history of p ain, atypical symptoms or earlier fractures in the arm, wrist or hand, it is important to add a neurophysiological examination.