Hand elevation: a new test for carpal tunnel syndrome.

Hand elevation can reproduce the symptoms of carpal tunnel syndrome. This phenomenon prompted the idea of developing a simple hand elevation test to diagnose carpal tunnel syndrome. A total of 200 hands in 118 patients diagnosed with carpal tunnel syndrome were tested prospectively from September 6, 1999, to February 3, 2000. Three provocative tests (hand elevation test, Phalen's test, and Tinel's test) were performed on each hand for both the experimental group (200 hands) and the control group (200 hands). McNemar chi-squared analysis was used to compare the sensitivity and specificity of the new hand elevation test with those of Phalen's test and Tinel's test. The sensitivity and specificity of the hand elevation test is 75.5% and 98.5% respectively. Phalen's test had 67.5% sensitivity and 91.0% specificity. Tinel's test had 67.5% sensitivity and 90.0% specificity. The difference in sensitivities between the hand elevation test and Phalen's test was significant (p = 0.05). No significant difference was found in the sensitivity between the hand elevation test and Tinel's test. The comparison of specificity of the hand elevation test and Phalen's test was significant (p = 0.001). Significance was also observed in specificity between the hand elevation test and Tinel's test (p = 0.001). In this study, the sensitivity and specificity of the elevation test were higher than those of Phalen's test and Tinel's test. Statistical analysis confirms the eligibility of the hand elevation test as a useful, provocative test.