Accuracy of clinical tests used in the detection of carpal tunnel syndrome: A literature review

Literature pertaining to the accuracy of clinical tests used in the examination and diagnosis of carpal tunnel syndrome (CTS) was reviewed. This review suggests that, while no test is 100% accurate, clinical examination has an important role in the diagnosis of CTS, Phalen's test had respectable levels of sensitivity and specificity. Tinel's sign may be present only in certain stages of CTS, but when present is quite specific. Other provocative tests have been described but insufficiently researched to determine their levels of usefulness. Early sensory changes can be assessed with either vibration perception testing or Semmes-Weinstein monofilaments. The tourniquet test is not a useful test. Loss of either 2-point discrimination or motor function should be anticipated only in more severe cases of CTS.