Most sensitive test for carpal tunnel syndrome –
Correct Answer: Phalen's test
Description: *Phalen&;s test / wrist flexion : the patient is asked to actively place the wrist in complete but unforced flexion . If tingling & numbness are produced in median nerve distribution of the hand within 60 seconds , the test is positive . it is the most sensitive provocative test , has a specificity of 80%. *Tinel &;s sign - to record the rate of regeneration of nerve clinically . * Tourniquet test : a pneumatic BP cuff is applied proximal to elbow & inflated higher than the patient&;s systolic BP .The test is positive if there is parasthesia or numbness in region of median nerve distribution of the hand . Is less reliable & is specific in 65% cases. * median nerve percussion test : tap the median nerve at the wrist gently ,test is positive if there is tingling sensation .seen in 45% cases only * median nerve compression test : direct pressure over both wrist by examiner .first phase of test is time taken for symptoms to appear (15 sec- 2min) .the second phase is the time taken for symptoms to disappear after the release. REF:textbook of ohopedics, John Ebenezer, 4th edition , pg.no.394
Category:
Orthopaedics
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