Correlating symptom severity index, clinical diagnostic criteria of CTS-6 and timed Phalen's test in clinical evaluation of carpal tunnel syndrome.

BACKGROUND

Carpal Tunnel Syndrome (CTS) poses significant diagnostic challenges, especially in resource-limited settings. Reliable tools such as the 6-item Symptom Severity Index, Timed Phalen's Test (TPT) and CTS-6 are promising but under investigated. Correlation between these tools and symptom severity remains underexplored.

AIM

To correlate the 6-item Symptom Severity Index and CTS-6 diagnostic tool with TPT in clinically diagnosed CTS cases, evaluating their diagnostic performance.

METHODS

Prospective cross-sectional study, conducted in a tertiary care hospital in eastern India. 105 patients were enrolled after fulfilling inclusion criteria, assessing them with the 6-item Symptom Severity Index, CTS-6 diagnostic tool and TPT. Pearson's and Spearman's correlation coefficients were used, and statistical significance was set at < 0.05.

RESULTS

Of 188 evaluated hands, TPT showed a significant negative correlation with CTS-6 scores (r = -0.59, < 0.0001), indicating lower scores with higher TPT values. CTS-6 scores positively correlated with symptom severity (r = 0.34, < 0.0001), indicating higher Symptom Severity Indices associated with increased diagnostic probability. Positive predictive value for TPT was 70.1%, with sensitivity of 83.7% and specificity of 61.1%. Symptom Severity Indexing demonstrated higher sensitivity (100%) but lower specificity (3.3%).

CONCLUSIONS

This study highlights the utility of integrating subjective and objective assessment tools in CTS diagnosis. The findings underscore the importance of comprehensive evaluation and suggest the potential value of TPT as an adjunctive diagnostic tool. Further research is warranted to validate these findings and refine diagnostic algorithms for CTS management.