Assessment of a diagnostic questionnaire and protocol for management of carpal tunnel syndrome

One hundred and fifty-two patients with suspected carpal tunnel syndrome (CTS) completed a questionnaire, including questions about the location of paraesthesia, nocturnal pain, the effect of shaking the hand, relief by use of a wrist splint and impairment of manual dexterity. A score was derived from the symptom questionnaire and clinical signs including Tinel's test, Phalen's test, and altered sensation. Nerve conduction studies (NCS) were done in 91 cases in which the diagnosis of CTS was in doubt. A threshold questionnaire score was selected as indicating a diagnosis of CTS. Sixty-six patients were predicted to have CTS. When compared with the results of NCS this score had a specificity of 67% and sensitivity of 82%. Ninety-five patients underwent carpal tunnel release. A management model has been developed based on the questionnaire score for symptoms and signs.