A new diagnostic provocation test for carpal tunnel syndrome: Okutsu test

Many authors have reported various clinical provocation tests for diagnosis of carpal tunnel syndrome, however, some tests cannot be administered correctly on patients who suffer from restricted wrist joint movement. We compiled positive rates from a new diagnostic provocation test (Okutsu test) carried out on 3474 hands, and compared them and their success rates with results from other provocation tests performed on these same hands. The Okutsu test positive rate was 72.4%. There were statistical differences between Phalen test (69.8%) and wrist-extension test (60.2%) results. The Okutsu test success rate was 99.9% and there were statistical differences between Phalen test (52.8%) and wrist-extension test (56.8%) results. There were no statistical differences between percussion test at the wrist results in positive rate (71.1%) and in success rate (99.7%). The Okutsu test positive rate is high and it serves as a reliable screening test for clinical diagnosis of carpal tunnel syndrome.