Rapid Screening for Carpal Tunnel Syndrome: A Novel Method and Comparison With Established Others.

PURPOSE: The authors have observed that in healthy people, the Ulnar wrist-to-first dorsal interosseous distal motor latency does not differ significantly compared with median wrist-to-abductor pollicis brevis distal motor latency. The aim of our study was to investigate whether the difference between these two latencies can be used as a screening tool for diagnosing carpal tunnel syndrome and how this technique compares with other established techniques.

METHODS

The study was set up as a prospective observational study. As gold standard for the clinical diagnosis of carpal tunnel syndrome, the authors used the opinion of two neurologists who independently examined the patients. A third neurologist, also independently, performed the electrophysiological study.

RESULTS

Eighty-four subjects, 42 patients and 42 age- and sex-matched controls, participated in the study. Among all subjects using a receiver operating characteristic curve analysis, the area under the curve was 0.924 (95% CI, 0.857-0.991; SE, 0.034; P < 0.001). To detect carpal tunnel syndrome, at a cutoff score of equal to or greater than 0.575 milliseconds, our technique showed a sensitivity of 91%, a specificity of 93%, a positive predictive value of 93%, and a negative predictive value of 91%. Compared with other "classical" techniques, our technique showed better area under the receiver operating characteristic curve and better Youden index.

CONCLUSIONS

The median wrist-to-abductor pollicis brevis motor latency minus ulnar wrist-to-first dorsal interosseous motor latency may be used as a novel rapid screening tool of patients suffering from carpal tunnel syndrome.