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Egyptian Rheumatology and Rehabilitation
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Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome

Egyptian Rheumatology and Rehabilitation volume 45, pages 57–64 (2018)Cite this article

Abstract

Context

There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS).

Aim

The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS.

Patients and methods

This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation.

Results

The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients.

Conclusion

CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS.

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Authors and Affiliations

  1. Department of Physical Medicine, Rehabilitation and Rheumatology, Faculty of Medicine, Mansoura University, El-Gomhoria Street, Mansoura, P.O. 35516, Egypt

    Sara E. Hegab, Mohamed K. Senna, Eman A. Hafez (MD) & Seif E. A. Farag

Authors
  1. Sara E. Hegab
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  2. Mohamed K. Senna
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  3. Eman A. Hafez
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  4. Seif E. A. Farag
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Correspondence to Eman A. Hafez.

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Hegab, S.E., Senna, M.K., Hafez, E.A. et al. Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome. Egypt Rheumatol Rehabil 45, 57–64 (2018). https://doi.org/10.4103/err.err_41_17

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  • DOI: https://doi.org/10.4103/err.err_41_17

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