Diagnostic Value of Tinel Sign and Phalen Test in Patients with Tingling Sensation on Hands: An Electrophysiologic Analysis

J Korean Assoc EMG Electrodiagn Med 2011;13(1):18-24.
Published online June 1, 2011.

Abstract

Objectives: To evaluate the diagnostic value of Tinel sign and Phalen test through electrophysiologic analysis in patients with numb hands. Methods: Electrophysiologic findings were analyzed retrospectively in 430 patients with numb hands. 144 hands were diagnosed as normal, 341 as CTS, and 141 as cervical radiculopathy. The severity of CTS was classified into mild, moderate, severe. Positive rates of Tinel sign and Phalen test were compared in each group and the rates were analyzed according to the electrophysiologic severity of CTS. Results: Positive rate of Tinel sign and Phalen test were 35% and 20% in normal, 59%, 54% in CTS and 31%, 15% in cervical radiculopathy. Positive rate of Tinel sign was significantly higher in the severe CTS group (p<0.001). Phalen test revealed significant lower positive rate in mild group (p=0.01). Conclusions: The positive rates of Tinel sign and Phalen test were highest in CTS and had a diagnostic value of predicting severity. However, there are possibilities of false positive tests since patients with normal electrophysioloigc test and cervical radiculopathy showed have positive results in Tinel sign and Phalen test.

Key Words: Tinel sign, Phalen test, Carpal tunnel syndrome, Sensitivity, Specificity