[Value of clinical diagnosis in carpal tunnel syndrome].

The aim of this study was to examine sensitivity and specificity of Durkan test in 54 patients with carpal tunnel syndrome confirmed by electrophysiological testing, as compared to a control group of 54 patients without clinical signs of the syndrome. Sensitivity and specificity of Durkan test alone, as well as in combination with Phalen test and Hoffmann-Tinel test, were determined. The sensitivity of Durkan test was 0.87, its specificity was 0.96. The sensitivity of Phalen test was 0.85 with a specificity of 0.96. It was discovered that the combination of Phalen with Durkan test achieved a sensitivity of 0.94 and a specificity of 0.96, thus equalling the respective values for electrophysiological testing (nerve conduction velocity, electromyography) which so far is regarded as the golden standard diagnostic test for carpal tunnel syndrome. If Hoffmann-Tinel test is included as a further clinical parameter, then both sensitivity and specificity reach 0.96. This study, therefore, raises the question of whether costly electrophysiological testing is in fact necessary before surgery for carpal tunnel syndrome, when the clinical tests have already proven positive.