A systematic review of the clinical diagnostic tests for carpel tunnel syndrome

The purpose of this report was to critically review studies of the clinical diagnostic tests for carpal tunnel syndrome. The reports were located thro ugh Medline, Current Contents, related readings, and the reference lists of the articles. They all explored the use of clinical diagnostic tests for c arpal tunnel syndrome compared with the results of NCS. Criteria for system atically reviewing the studies were developed, tested for reliability, and applied to the studies. Many studies did not have sufficient detail to allo w repetition of the protocol by other researchers. The sensitivities and sp ecificities reported for each can he compared with the quality criteria rat ings they each received. The literature supports the use of the wrist flexi on and carpel compression test and suggests that 2-point discrimination has low sensitivity for diagnosing carpal tunnel syndrome. Many reports do not include methodology, which makes the results difficult to reproduce and to apply to other populations. Copyright (C) 2000 by the American Society for Surgery of the Hand.