Journal article
Scratch Collapse Test for Evaluation of Carpal and Cubital Tunnel Syndrome
The Journal of hand surgery (American ed.), Vol.33A(9), pp.1518-1524
2008
DOI: 10.1016/j.jhsa.2008.05.022
PMID: 18984333
Abstract
Purpose: The purpose of this study was to evaluate the clinical usefulness of a new test, the scratch collapse test, for the diagnosis of carpal tunnel syndrome and cubital tunnel syndrome.
Methods: The scratch collapse test was prospectively compared with Tinel's sign and flexion/nerve compression in 169 patients and 109 controls. One hundred nineteen patients were diagnosed with carpal tunnel syndrome and 70 patients were diagnosed with cubital tunnel syndrome based on history, examination, and positive electrodiagnostic test. For the new test, the patient resisted bilateral shoulder external rotation with elbows flexed. The area of suspected nerve compression was lightly "scratched," and then resisted shoulder external rotation was immediately repeated. Momentary loss of shoulder external rotation resistance on the affected side was considered a positive test. The sensitivity, specificity, and predictive values were calculated.
Results: For carpal tunnel syndrome, sensitivities were 64%, 32%, and 44% for the scratch collapse test, Tinel's test, and wrist flexion/compression test, respectively. For cubital tunnel syndrome, sensitivities were 69%, 54%, and 46% for the scratch collapse test, Tinel test, and elbow flexion/compression test, respectively. The scratch collapse test had the highest negative predictive value (73%) for carpal tunnel syndrome. Tinel's test had the highest negative predictive value (98%) for cubital tunnel syndrome. Specificity and positive predictive values were high for all of the tests.
Conclusions: The scratch collapse test had significantly higher sensitivity than Tinel's test and the flexion/nerve compression test for carpal tunnel and cubital tunnel syndromes. Accuracy for this test was 82% for carpal tunnel syndrome and 89% for cubital tunnel syndrome. This novel test provides a useful addition to existing clinical maneuvers in the diagnosis of these common nerve compression syndromes.
Details
- Title: Subtitle
- Scratch Collapse Test for Evaluation of Carpal and Cubital Tunnel Syndrome
- Creators
- Christine J CHENG - Kansas City Bone & Joint Clinic, Overland Park, KS, United StatesBrendan MACKINNON-PATTERSON - Kansas City Bone & Joint Clinic, Overland Park, KS, United StatesJohn L BECK - Kansas City Bone & Joint Clinic, Overland Park, KS, United StatesSusan E MACKINNON - Kansas City Bone & Joint Clinic, Overland Park, KS, United States
- Resource Type
- Journal article
- Publication Details
- The Journal of hand surgery (American ed.), Vol.33A(9), pp.1518-1524
- Publisher
- Elsevier; New York, NY
- DOI
- 10.1016/j.jhsa.2008.05.022
- PMID
- 18984333
- ISSN
- 0363-5023
- eISSN
- 1531-6564
- Language
- English
- Date published
- 2008
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040224602771
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