The forearm elevation-compression test: a novel test for carpal tunnel syndrome.

IF 7.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

QJM: An International Journal of Medicine Pub Date : 2024-11-01 DOI:10.1093/qjmed/hcae121

C H Hawkes, G Cutter

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引用次数: 0

Abstract

Background: As the time available to spend with patients decreases, a rapid test for bedside diagnosis of carpal tunnel syndrome (CTS) could be useful.

Design and methods: We describe the forearm elevation-compression test (FECT) in this context. The FECT was assessed in 40 patients with clinically suspected CTS and compared to Tinel's and Phalen's signs. Routine electromyography and nerve conduction tests (EMG/NCT) were performed in all cases. In addition, 85 healthy controls were examined by FECT and compared to the patient group.

Results: All three provocative tests, particularly FECT, were frequently positive in suspected CTS. Neurophysiological tests were normal in 5 of 40 cases of clinically suspected CTS, and the FECT was positive in all of these suggesting a positive predictive value of 87.5% if one accepts EMG/NCT as the reference. Amongst the healthy controls, 18 of 85 (21.2%) were positive on the FECT suggestive of a high false-positive rate or subclinical disease.

Conclusion: It is proposed that the FECT is a useful addition to the clinical examination of suspected CTS. Although the positive rate may be falsely elevated, this is offset by restricting the latency for tingling onset to 10 s or less (FECT2).

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前臂抬高加压试验：一种新型的腕管综合征试验。

背景：目的：在此背景下，我们介绍了前臂抬高加压试验（FECT）。对 40 名临床疑似腕管综合征患者进行了 FECT 评估，并与 Tinel 征和 Phalen 征进行了比较。所有病例均进行了常规肌电图和神经传导测试（EMG/NCT）。此外，85 名健康对照者也接受了 FECT 检查，并与患者组进行了比较：结果：在疑似 CTS 患者中，所有三种诱发试验，尤其是 FECT 试验经常呈阳性。在 40 例临床疑似 CTS 患者中，有 5 例的神经电生理检测结果正常，而 FECT 检测结果全部呈阳性，这表明如果将 EMG/NCT 作为参考，阳性预测值可达 87.5%。在健康对照组中，85 例中有 18 例（21.2%）在 FECT 中呈阳性，表明假阳性率较高或存在亚临床疾病：结论：FECT 是对疑似 CTS 临床检查的有益补充。虽然阳性率可能会出现假阳性，但将刺痛发生的潜伏期限制在 10 秒或更短时间（FECT2）可抵消这一假阳性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

QJM: An International Journal of Medicine 医学-医学：内科

CiteScore

6.90

自引率

5.30%

发文量

263

审稿时长

4-8 weeks

期刊介绍： QJM, a renowned and reputable general medical journal, has been a prominent source of knowledge in the field of internal medicine. With a steadfast commitment to advancing medical science and practice, it features a selection of rigorously reviewed articles. Released on a monthly basis, QJM encompasses a wide range of article types. These include original papers that contribute innovative research, editorials that offer expert opinions, and reviews that provide comprehensive analyses of specific topics. The journal also presents commentary papers aimed at initiating discussions on controversial subjects and allocates a dedicated section for reader correspondence. In summary, QJM's reputable standing stems from its enduring presence in the medical community, consistent publication schedule, and diverse range of content designed to inform and engage readers.