Background Carpal tunnel syndrome is most common nerve entrapment syndrome. It occurs by compression of median nerve in carpal tunnel at the wrist.
Objectives In this study we compared the clinical findings and some provocative tests (Tinnel, Phalen, reverse phalen) with electrophysological examination (ENMG) results.
Methods This study was carried out on 48 patients who had pain, numbness, tingling and weakness complaints in at least one hand. Provocative tests and ENMG investigation were applied for each patient whom suspected for carpal tunnel syndrome.
67 hands of 48 patients which represent positive sign for carpal tunnel syndrome were evaluated and compared with ENMG positivity. In order to evaluate validity of provacative tests, chi-square test was used. Positive-negative predictive values of provocative tests also investigated.
Results 20 patients had bilateral complaints, 28 patients had complaints only in one hand. When compared with ENMG results, reverse Phalen test was founded most spesific test (%78.8). This was followed by Tinnel test%72.3 and Phalen test%70.2.
Conclusion We concluded that provacative tests for ENMG have increased sensitivity, for that reason can be applied in epidemiological studies for carpal tunnel syndrome. But to make an definite diagnosis of carpal tunnel syndrome electrophysiological examination should be applied.
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White JC, Hansen SR, Johnson RK. A comparison of EMG procedures in the carpal tunnel syndrome with clinical-EMG correlations. Muscle Nerve 1998;11;1177–82
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