TINEL’S WITH TOURNIQUET TEST FOR THE DIAGNOSIS OF CARPAL TUNNEL SYNDROME- A NEW PROVOCATIVE CLINICAL TEST
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 63
Abstract
BACKGROUND Commonly used clinical tests to diagnose Carpal Tunnel Syndrome (CTS) are provocative tests, which involves compression of median nerve at carpal tunnel. Some of these tests are Phalen’s test, Durkan’s test and Tinel’s sign. MATERIALS AND METHODS This was a descriptive study. Sample size was taken conveniently. 134 consecutive hands (in patients with symptoms suggestive of CTS) were tested with a new clinical test combining Tourniquet test with Tinel’s sign (T, TT, TTT) to increase the sensitivity and specificity of both of these tests if done separately. Out of these hands, seventy-one (n) were included for which all data were available. Attempts were made to grade the carpal tunnel syndrome based on severity, similar to grading done for nerve conduction study report. The results obtained were analysed and compared with that of nerve conduction study for carpal tunnel syndrome. RESULTS The statistical methods used were chi square test (2*6 cross contingency tabulation), Pearson Correlation Coefficient analysis. The new clinical test (Tinel’s, Tourniquet, Tinel’s with tourniquet- T, TT, TTT) was correlated with the Nerve Conduction Study (NCS) for carpal tunnel syndrome. Pearson correlation coefficient was calculated for both the tests (new test and NCS), which showed positive correlation when ‘n’ was analysed (0.2339, p < 0.05). When the tests were analysed with two grades considered up or down, there was a 66.2% correlation. Chi square test (2*6 tabulation) returned significant p value. CONCLUSION The new clinical test for carpal tunnel syndrome- Tinel’s with Tourniquet test (T, TT, TTT) increases the sensitivity of Tinel’s test, which is usually considered a clinical test with high specificity. It also helped to assess the severity of the disease, thus helping in decision-making regarding further treatment. Even though the analysis returned a positive correlation, bigger sample size is required to further validate this new test.
Authors and Affiliations
Sadanandan A. N. , Rijesh P
Keywords
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- EP ID EP231433
- DOI 10.14260/Jemds/2017/989
- Views 98
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