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QUESTION: What is the accuracy of the history and physical examination in diagnosing carpal tunnel syndrome (CTS)?
Studies were identified by searching Medline (1966 to February 2000) with the terms carpal tunnel syndrome, diagnosis, Tinel, Hoffman, and Phalen. References of relevant articles were reviewed. The search was limited to English language studies.
Studies were selected if they addressed the diagnosis of CTS in adults; patients presented with symptoms suggestive of CTS; a clear description of the physical examination was provided; the results of the physical examination and electrodiagnostic studies were apparently assessed independently; and numbers needed to calculate sensitivity, specificity, and likelihood ratios (LRs) were available.
2 independent reviewers extracted data on history, physical findings, and CTS …
Source of funding: no external funding.
For correspondence: Dr C A D'Arcy, Division of Rheumatology, University of Washington Health Sciences Center, 1959 North East Pacific Street, Box 356428, Seattle, WA 98195, USA. Fax + 1 206 685 9397.