Hand elevation: A new test for carpel tunnel syndrome

Hand elevation can reproduce the symptoms of carpal tunnel syndrome. This p henomenon prompted the idea of developing a simple hand elevation test to d iagnose carpal tunnel syndrome. A total of 200 hands in 118 patients diagno sed with carpal tunnel syndrome were tested prospectively from September 6, 1999, to February 3, 2000. Three provocative tests (hand elevation test, P halen's test, and Tinel's test) were performed on each hand for both the ex perimental group (200 hands) and the control group (200 hands). McNemar chi -squared analysis was used to compare the sensitivity and specificity of th e new hand elevation test with those of Phalen's test and Tinel's test. The sensitivity and specificity of the hand elevation test is 75.5% and 98.5% respectively. Phalen's test had 67.5% sensitivity and 91.0% specificity. Ti nel's test had 67.5% sensitivity and 90.0% specificity. The difference in s ensitivities between the hand elevation test and Phalen's test was signific ant (p = 0.05). No significant difference was found in the sensitivity betw een the hand elevation test and Tinel's test. The comparison of specificity of the hand elevation test and Phalen's test was significant (p = 0.001). Significance was also observed in specificity between the hand elevation te st and Tinel's test (p = 0.001). In this study, the sensitivity and specifi city of the elevation test were higher than those of Phalen's test and Tine l's test. Statistical analysis confirms the eligibility of the hand elevati on test as a useful, provocative test.