Clinical tests for carpal tunnel syndrome in contemporary practice

A study conducted to establish the most accurate combination of questionnaire and physical signs for the diagnosis of carpal tunnel syndrome. Nerve conduction studies confirmed 70 patients with having carpal tunnel syndrome who were enrolled along with 70 age- and sex-matched controls. Patients were assessed using a symptom questionnaire, Phalen's test, Hoffmann-Tinel's sign, hand elevation test, carpal compression test, tourniquet test, pressure aesthesiometry and two-point discrimination. Through multivariate analysis, the best combination of tests was tourniquet, carpal compression and Phalen's tests but the difference between these and hand elevation test alone was negligible. The hand elevation test may be used in isolation and is superior to questionnaires and other physical signs in the clinical diagnosis of carpal tunnel syndrome.