Median Nerve Symptoms, Signs, and Electrodiagnostic Abnormalities Among Working Adults

The Journal of the American Academy of Orthopaedic Surgeons
Kurt HegmannJ Mark Melhorn

Abstract

Diagnostic screening tests for carpal tunnel syndrome (CTS) have not been rigorously assessed in large populations. This study is a cross-sectional analysis from a prospective cohort study. Participants' (n = 1,194) symptoms and disease prevalence were measured. Sensitivity, specificity, and positive and negative predictive values (NPVs) were calculated. When defining CTS as tingling/numbness in at least two median nerve-served digits and an abnormal median nerve conduction study, the prevalence was 8.9%. The sensitivity of paresthesias with nocturnal awakening was 77.4%. The sensitivity of the Phalen sign was 52.8% and that of the Hoffman-Tinel sign was only 37.7%. The highest sensitivity (77.4%) for a case definition of CTS in this population of workers was for nocturnal tingling/numbness in a median nerve distribution, and the highest specificity (97.5%) was for continuous tingling/numbness. The Phalen sign has a sensitivity of 52.8% and NPV of 95%, suggesting that the NPV is of particular diagnostic value. Hoffman-Tinel signs seem primarily helpful for the NPV (93.7%). Level II diagnostic study.

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Citations

May 16, 2019·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·A M MagomedovaD M Merkulova
Dec 24, 2021·The Journal of International Medical Research·Nhu Quynh VoThanh Thao Nguyen
Dec 31, 2021·Voprosy kurortologii, fizioterapii, i lechebnoĭ fizicheskoĭ kultury·M Kh Al-ZamilN B Korchazhkina

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