DIAGNOSTIC ACCURACY OF PROVOCATIVE TESTS FOR THE DETECTION OF CARPAL TUNNEL SYNDROME (CTS) BY TAKING THE ELECTRO-DIAGNOSTIC TEST AS A GOLD STANDARD IN CLINICALLY SUSPECTED PATIENTS

Abstract

Background: Screening for carpal tunnel syndrome has been made possible with the development of provocative tests. These procedures involve exerting pressure or stretching the median nerve in order to provoke symptoms.

Objective: The diagnostic accuracy of provocative tests for the detection of carpal tunnel syndrome (CTS) by taking the Electro-diagnostic Test as a gold standard in patients with clinically suspected CTS at Tertiary Care Hospital

Material and Methods: A cross-sectional study was carried, 218 patients between the ages of 18 and 80 years who had a clinical suspicion of carpal tunnel syndrome were included during the period 03-05-2024 to 30-11-2024. To verify the diagnosis, participants were subjected to electrodiagnostic testing. All provocative tests, including Phalen's test and Durkan's test were carried out in accordance with the protocols that were established initially. In order to determine the diagnostic accuracy of the provocative tests, sensitivity, specificity, and predictive values were determined.

Results: Within the sample, there were 138 males (63.3%) and 80 females (36.7%). The average age was 40.25±15.32 years. Tinel's signal had the best diagnostic accuracy (91.7%) with sensitivity and specificity of 94.7% and 87.4%, respectively. Phalen's test had the lowest diagnostic accuracy (65.13%), with sensitivity and specificity of 66.4% and 63.2%, respectively. The diagnosis accuracy of Phdurkan was found to be 70.18 percent, with some variance occurring depending on the demographics of patient and their clinical profile.

Conclusion:  The most reliable diagnostic tool for identifying carpal tunnel syndrome (CTS) is Tinel's signal, followed by Durkan's test and Phalen's test.