Validity of provocative tests in the diagnosis of carpal tunnel syndrome

Abstract EN

Aim: Evaluation of the validity of the three provocative tests (wrist flexion test, median nerve percussion test and tourniquet test) in the diagnosis of carpal tunnel syndrome.

Material & Methods: We evaluated the results of performing these tests in a group of patients (149 hands) and in a control group composed of 32 healthy subjects (58 hands).

Both groups were subjected to electro diagnostic studies.

The sensitivity, reliability and specificity of each of these three provocative tests were calculated to examine for the validity of each in diagnosis.

Results: We found that the wrist flexion test was the most valid as it was the most sensitive and reliable, although it is not the most specific.

The percussion test comes next in validity as it proved less sensitive and reliable, although more specific, than the wrist flexion test.

The tourniquet test was quite insensitive with poor reliability and low specificity.

It proved to be invalid and should not be used as a routine screening test in the diagnosis of carpal tunnel syndrome.