Value of clinical provocative tests in carpal tunnel syndrome.

The value of five provocative tests for the diagnosis of carpal tunnel syndrome (CTS) was assessed in four groups: 54 hands with confirmed CTS, 12 with typical symptoms but normal electrophysiological studies, 16 hands in persons with diabetes and 81 hands in normal controls. Compared to normal controls the Tinel sign and the closed first test are highly specific; Durkan's compression test is not useful to discriminate between symptomatic patients with and without EMG disturbances. The closed fist test is specific in these situations.