Clinical and electrodiagnostic testing of Carpal Tunnel Syndrome. A narrative review

Journal of Orthopaedic and Sports Physical Therapy

Volumn 34, Issue 10, 2004, Pages 565-588

  MacDermid, Joy C ^a,b,d   Doherty, Tim ^c  

^a MCMASTER UNIVERSITY   (Canada)

^b ST JOSEPH S HEALTH CENTRE   (Canada)

^c UNIVERSITY OF WESTERN ONTARIO   (Canada)

^d MCMASTER UNIVERSITY   (Canada)

Author keywords

Hand; Median nerve; Wrist

Indexed keywords

CARPAL TUNNEL SYNDROME; CLINICAL FEATURE; DIAGNOSTIC ACCURACY; DIAGNOSTIC PROCEDURE; DIAGNOSTIC TEST; DISEASE COURSE; DISEASE SEVERITY; ELECTRODIAGNOSIS; HUMAN; MUSCLE ATROPHY; NERVE COMPRESSION; NEUROPATHY; PATHOPHYSIOLOGY; REVIEW; THENAR;

EID: 6344258236     PISSN: 01906011     EISSN: None     Source Type: Journal    
DOI: 10.2519/jospt.2004.34.10.565     Document Type: Review

References (149)

1. Ahn DS. Hand elevation: a new test for carpal tunnel syndrome. Ann Plast Surg. 2001;46:120-124.
2. Alfonso MI, Dzwierzynski W. Hoffman-Tinel sign. The realities. Phys Med Rehabil Clin N Am. 1998;9:721-736.
3. Atroshi I, Breidenbach WC, McCabe SJ. Assessment of the carpal tunnel outcome instrument in patients with nerve-compression symptoms. J Hand Surg [Am]. 1997;22:222-227.
4. Bell MS. Quantitative abductor pollicis brevis strength testing. J Hand Surg [Am]. 2001;26:362.
5. Bell-Krotoski J. Pocket Filaments and specifications for the Semmes-Weinstein Monofilaments. J Hand Ther. 1990;3:1-6.
6. Bell-Krotoski J, Tomancik E. The repeatability of testing with Semmes-Weinstein monofilaments. J Hand Surg [Am]. 1987;12:155-161.
7. Bell-Krotoski J, Weinstein S, Weinstein C. Testing sensibility, including touch-pressure, two-point discrimination, point localization, and vibration. J Hand Ther. 1993;6:114-123.
8. Bell-Krotoski JA, Buford WL, Jr. The force/time relationship of clinically used sensory testing instruments. J Hand Ther. 1997;10:297-309.
9. Bell-Krotoski JA, Fess EE, Figarola JH, Hiltz D. Threshold detection and Semmes-Weinstein monofilaments. J Hand Ther. 1995;8:155-162.
10. Bessette L, Keller RB, Lew RA, et al. Prognostic value of a hand symptom diagram in surgery for carpal tunnel syndrome. J Rheumatol. 1997;24:726-734.
11. Bland JD. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve. 2000;23:1280-1283.
12. Bland JD. The value of the history in the diagnosis of carpal tunnel syndrome. J Hand Surg [Br]. 2000;25:445-450.
13. Boeckstyns ME, Sorensen AI. Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published series. J Hand Surg [Br]. 1999;24:9-15.
14. Boles DM, Tobias PV, Spiro F. Carpal tunnel syndrome due to compression by an anomalous median artery. Surg Neurol. 1982;17:99-100.
15. Borg K, Lindblom U. Increase of vibration threshold during wrist flexion in patients with carpal tunnel syndrome. Pain. 1986;26:211-219.
16. Braun RM, Davidson K, Doehr S. Provocative testing in the diagnosis of dynamic carpal tunnel syndrome. J Hand Surg [Am]. 1989;14:195-197.
17. Brown WF, Ferguson GG, Jones MW, Yates SK. The location of conduction abnormalities in human entrapment neuropathies. Can J Neurol Sci. 1976;3:111-122.
18. Brown WF, Watson B. Pathophysiology of conduction in peripheral nerves. In: Brown WF, Bolton CF, eds. Neuromuscular Function and Disease: Basic, Clinical, and Electrodiagnostic Aspects. Philadelphia, PA: W.B. Saunders Company; 2002:56-95.
19. Bruske J, Bednarski M, Grzelec H, Zyluk A. The usefulness of the Phalen test and the Hoffmann-Tinel sign in the diagnosis of carpal tunnel syndrome. Acta Orthop Belg. 2002;68:141-145.
20. Burke DT, Burke MA, Bell R, Stewart GW, Mehdi RS, Kim HJ. Subjective swelling: a new sign for carpal tunnel syndrome. Am J Phys Med Rehabil. 1999;78:504-508.
21. Carroll GJ. Comparison of median and radial nerve sensory latencies in the electrophysiological diagnosis of carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol. 1987;68:101-106.
22. Chell J, Stevens A, Davis TR. Work practices and histopathological changes in the tenosynovium and flexor retinaculum in carpal tunnel syndrome in women. J Bone Joint Surg Br. 1999;81:868-870.
23. Choi SJ, Ahn DS. Correlation of clinical history and electrodiagnostic abnormalities with outcome after surgery for carpal tunnel syndrome. Plast Reconstr Surg. 1998;102:2374-2380.
24. Cioni R, Passero S, Paradiso C, Giannini F, Battistini N, Rushworth G. Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. J Neurol. 1989;236:208-213.
25. Dawson GD, Scolt JW. The recording of nerve action potentials through the skin in man. J Neurol Neurosurg Psychiatry. 1956;12:259-267.
26. Dellon AL. Clinical use of vibratory stimuli to evaluate peripheral nerve injury and compression neuropathy. Plast Reconstr Surg. 1980;65:466-476.
27. Dellon AL. The moving two-point discrimination test: clinical evaluation of the quickly adapting fiber/receptor system. J Hand Surg [Am]. 1978;3:474-481.
28. Dellon AL. Tinel or not Tinel. J Hand Surg [Br]. 1984;9:216.
29. Dellon AL, Keller KM. Computer-assisted quantitative sensorimotor testing in patients with carpal and cubital tunnel syndromes. Ann Plast Surg. 1997;38:493-502.
30. Ditmars DM, Jr., Houin HP. Carpal tunnel syndrome. Hand Clin. 1986;2:525-532.
31. Durkan JA. The carpal-compression test. An instrumented device for diagnosing carpal tunnel syndrome. Orthop Rev. 1994;23:522-525.
32. Durkan JA. A new diagnostic test for carpal tunnel syndrome. J Bone Joint Surg Am. 1991;73:535-538.
33. Dvir Z. Grade 4 in manual muscle testing: the problem with submaximal strength assessment. Clin Rehabil. 1997;11:36-41.
34. Ferry S, Silman AJ, Pritchard T, Keenan J, Croft P. The association between different patterns of hand symptoms and objective evidence of median nerve compression: a community-based survey. Arthritis Rheum. 1998;41:720-724.
35. Fertl E, Wober C, Zeitlhofer J. The serial use of two provocative tests in the clinical diagnosis of carpal tunel syndrome. Acta Neurol Scand. 1998;98:328-332.
36. Gelberman RH, Rydevik BL, Pess GM, Szabo RM, Lundborg G. Carpal tunnel syndrome. A scientific basis for clinical care. Orthop Clin North Am. 1988;19:115-124.
37. Gelberman RH, Szabo RM, Williamson RV, Dimick MP. Sensibility testing in peripheral-nerve compression syndromes. An experimental study in humans. J Bone Joint Surg Am. 1983;65:632-638.
38. Gellman H, Gelberman RH, Tan AM, Botte MJ. Carpal tunnel syndrome. An evaluation of the provocative diagnostic tests. J Bone Joint Surg Am. 1986;68:735-737.
39. Gelmers HJ. The significance of Tinel's sign in the diagnosis of carpal tunnel syndrome. Acta Neurochir (Woen). 1979;49:255-258.
40. Gerr F, Letz R, Harris-Abbott D, Hopkins LC. Sensitivity and specificity of vibrometry for detection of carpal tunnel syndrome. J Occup Environ Med. 1995;37:1108-1115.
41. Gilliatt RW. Electrophysiology of peripheral neuropathiesan overview. Muscle Nerve. 1982;5:S108-116.
42. Gilliatt RW. Physical injury to peripheral nerves. Physiologic and electrodiagnostic aspects. Mayo Clin Proc. 1981;56:361-370.
43. Gilliatt RW, Sears TA. Sensory nerve action potentials in patients with peripheral nerve lesions. J Neurochem. 1958;21:109-118.
44. Graham B, Regehr G, Wright JG. Delphi as a method to establish consensus for diagnostic criteria. J Clin Epidemiol. 2003;56:1150-1156.
45. Graham B, Wright JG. Development of Diagnostic Criteria for Carpal Tunnel Syndrome [research grant]. North York, Ontario, Canada: Physicians' Services Incorporated Foundation; 1998-2000.
46. Gupta SK, Benstead TJ. Symptoms experienced by patients with carpal tunnel syndrome. Can J Neurol Sci. 1997;24:338-342.
47. Heller L, Ring H, Costeff H, Solzi P. Evaluation of Tinel's and Phalen's signs in diagnosis of the carpal tunnel syndrome. Eur Neurol. 1986;25:40-42.
48. Hislop HJ, Montgomery J. Daniel's and Worthington's Muscle Testing: Techniques of Manual Examination. Philadelphia, PA: W.B. Saunders Company; 2002.
49. Horch K, Hardy M, Jimenez S, Jabaley M. An Automated Tactile Tester for evaluation of cutaneous sensibility. J Hand Surg [Am]. 1992;17:829-837.
50. Hubbard MC, MacDermid JC, Kramer JF, Birmingham TB. Quantitative vibration threshold testing in carpal tunnel syndrome: analysis strategies for optimizing reliability. J Hand Ther. 2004;17:24-30.
51. Hutton P, Kernohan J, Birch R. An anomalous flexor digitorum superficialis indicis muscle presenting as carpal tunnel syndrome. Hand. 1981;13:85-86.
52. Jablecki CK, Andary MT, Floeter MK, et al. Practice parameter: electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2002;58:1589-1592.
53. Jackson DA, Clifford JC. Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys Med Rehabil. 1989;70:199-204.
54. Jeng OJ, Radwin RG. A gap detection tactility test for sensory deficits associated with carpal tunnel syndrome. Ergonomics. 1995;38:2588-2601.
55. Jeng OJ, Radwin RG, Fryback DG. Preliminary evaluation of a sensory and psychomotor functional test battery for carpal tunnel syndrome: Part 1Confirmed cases and normal subjects. Am Ind Hyg Assoc J. 1997;58:852-860.
56. Jetzer T, Dellon LA, Mitterhauser MD. The use of PSSD testing in comparison to vibrotactile testing of vibration exposed workers. Cent Eur J Public Health. 1995;3 Suppl:49-51.
57. Jordan R, Carter T, Cummins C. A systematic review of the utility of electrodiagnostic testing in carpal tunnel syndrome. Br J Gen Pract. 2002;52:670-673.
58. Kamath V, Stothard J. A clinical questionnaire for the diagnosis of carpal tunnel syndrome. J Hand Surg [Br]. 2003;28:455-459.
59. Karl AI, Carney ML, Kaul MP. The lumbrical provocation test in subjects with median inclusive paresthesia. Arch Phys Med Rehabil. 2001;82:935-937.
60. Kasch MC, Greengerg S, Muenzen PM. Competencies in hand therapy. J Hand Ther. 2003;16:49-58.
61. Kasdan ML. Complications of endoscopic and open carpal tunnel release. J Hand Surg [Am]. 2000;25:185.
62. Katims J. Limitations of quantitative sensory testing when patients are biased toward a bad outcome. Neurology. 1999;52:894; author reply 894-895.
63. Katims JJ. Current perception threshold mis-evaluation. J Occup Environ Med. 1995;37:790-793.
64. Katims JJ, Patil AS, Rendell M, et al. Current perception threshold screening for carpal tunnel syndrome. Arch Environ Health. 1991;46:207-212.
65. Katims JJ, Rouvelas P, Sadler BT, Weseley SA. Current perception threshold. Reproducibility and comparison with nerve conduction in evaluation of carpal tunnel syndrome. ASAIO Trans. 1989;35:280-284.
66. Katz JN, Larson MG, Sabra A, et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Intern Med. 1990;112:321-327.
67. Katz JN, Stirrat CR. A self-administered hand diagram for the diagnosis of carpal tunnel syndrome. J Hand Surg [Am]. 1990;15:360-363.
68. Kaul MP, Pagel KJ, Dryden JD. Lack of predictive power of the "tethered" median stress test in suspected carpal tunnel syndrome. Arch Phys Med Rehabil. 2000;81:348-350.
69. Kimura J. The carpal tunnel syndrome: localization of conduction abnormalities within the distal segment of the median nerve. Brain. 1979;102:619-635.
70. Krendel DA, Jobsis M, Gaskell PC, Jr., Sanders DB. The flick sign in carpal tunnel syndrome. J Neurol Neurosurg Psychiatry. 1986;49:220-221.
71. Kuntzer T. Carpal tunnel syndrome in 100 patients: sensitivity, specificity of multi-neurophysiological procedures and estimation of axonal loss of motor, sensory and sympathetic median nerve fibers. J Neurol Sci. 1994;127:221-229.
72. LaBan MM, Friedman NA, Zemenick GA. "Tethered" median nerve stress test in chronic carpal tunnel syndrome. Arch Phys Med Rehabil. 1986;67:803-804.
73. LaBan MM, MacKenzie JR, Zemenick GA. Anatomic observations in carpal tunnel syndrome as they relate to the tethered median nerve stress test. Arch Phys Med Rehabil. 1989;70:44-46.
74. Lambert EH. Diagnostic value of electrical stimulation of motor nerves. Clin Neurophysiol. 1962;22(suppl):9-16.
75. Levine DW, Simmons BP, Koris MI, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75:1585-1592.
76. Lew HL, Wang L, Robinson LR. Test-retest reliability of combined sensory index: implications for diagnosing carpal tunnel syndrome. Muscle Nerve. 2000;23:1261-1264.
77. Lindley SG, Kleinert JM. Prevalence of anatomic variations encountered in elective carpal tunnel release. J Hand Surg [Am]. 2003;28:849-855.
78. Lundborg G, Lie-Stenstrom AK, Sollerman C, Stromberg T, Pyykko I. Digital vibrogram: a new diagnostic tool for sensory testing in compression neuropathy. J Hand Surg [Am]. 1986;11:693-699.
79. MacDermid JC. Accuracy of clinical tests used in the detection of carpal tunnel syndrome: a literature review. J Hand Ther. 1991;4:169-176.
80. MacDermid JC, Kramer JF, McFarlane RM, Roth JH. Inter-rater agreement and accuracy of clinical tests used in diagnosis of carpal tunnel syndrome. Work. 1997;8:37-44.
81. MacDermid JC, Kramer JF, Roth JH. Decision making in detecting abnormal Semmes-Weinstein monofilament thresholds in carpal tunnel syndrome. J Hand Ther. 1994;7:158-162.
82. MacDermid JC, Wessel J. Clinical diagnosis of carpal tunnel syndrome: a systematic review. J Hand Ther. 2004;17:309-319.
83. Mackinnon SE. Pathophysiology of nerve compression. Hand Clin. 2002;18:231-241.
84. Mackinnon SE, Novak CB, Landau WM. Clinical diagnosis of carpal tunnel syndrome. JAMA. 2000;284:1924-1925; author reply 1925-1926.
85. Manente G, Torrieri F, Pineto F, Uncini A. A relief maneuver in carpal tunnel syndrome. Muscle Nerve. 1999;22:1587-1589.
86. Martin S. Carpal tunnel syndrome: a job-related risk. Am Pharm. 1991;NS31:21-24.
87. Massy-Westropp N, Grimmer K, Bain G. A systematic review of the clinical diagnostic tests for carpal tunnel syndrome. J Hand Surg [Am]. 2000;25:120-127.
88. Millesi H, Zoch G, Rath T. The gliding apparatus of peripheral nerve and its clinical significance. Ann Chir Main Memb Super. 1990;9:87-97.
89. Molitor PJ. A diagnostic test for carpal tunnel syndrome using ultrasound. J Hand Surg [Br]. 1988;13:40-41.
90. Mondelli M, Passero S, Giannini F. Provocative tests in different stages of carpal tunnel syndrome. Clin Neurol Neurosurg. 2001;103:178-183.
91. Mossman SS, Blau JN. Tinel's sign and the carpal tunnel syndrome. Br Med J (Clin Res Ed). 1987;294:680.
92. Nathan PA, Keniston RC, Meadows KD, Lockwood LS. The value of carpal compression test (CCT) as an alternative provocative clinical manoeuvre. J Hand Surg [Br]. 1997;22:823-825.
93. Nathan PA, Meadows KD, Doyle LS. Occupation as a risk factor for impaired sensory conduction of the median nerve at the carpal tunnel. J Hand Surg [Br]. 1988;13:167-170.
94. Nathan PA, Meadows KD, Doyle LS. Sensory segmental latency values of the median nerve for a population of normal individuals. Arch Phys Med Rehabil. 1988;69:499-501.
95. Neary D, Ochoa J, Gilliatt RW. Sub-clinical entrapment neuropathy in man. J Neurol Sci. 1975;24:283-298.
96. Nodera H, Herrmann DN, Holloway RG, Logigian EL. A Bayesian argument against rigid cut-offs in electrodiagnosis of median neuropathy at the wrist. Neurology. 2003;60:458-464.
97. Novak CB, Mackinnon SE, Brownlee R, Kelly L. Provocative sensory testing in carpal tunnel syndrome. J Hand Surg [Br]. 1992;17:204-208.
98. O'Gradaigh D, Merry P. A diagnostic algorithm for carpal tunnel syndrome based on Bayes's theorem. Rheumatology (Oxford). 2000;39:1040-1041.
99. Padua L, Lo Monaco M, Moretti C, Tonali P. Increase of the early clinical diagnosis of carpal tunnel syndrome over the last twenty years. Muscle Nerve. 1997;20:1045-1046.
100. Padua L, Lo Monaco M, Valente EM, Tonali PA. A useful electrophysiologic parameter for diagnosis of carpal tunnel syndrome. Muscle Nerve. 1996;19:48-53.
101. Padua L, Padua R, Aprile, Tonali P. Italian multicentre study of carpal tunnel syndrome. Differences in the clinical and neurophysiological features between male and female patients. J Hand Surg [Br]. 1999;24:579-582.
102. Padua L, Padua R, Aprile I, D'Amico P, Tonali P. Carpal tunnel syndrome: relationship between clinical and patient-oriented assessment. Clin Orthop. 2002;128-134.
103. Pagel KJ, Kaul MP, Dryden JD. Lack of utility of Semmes-Weinstein monofilament testing in suspected carpal tunnel syndrome. Am J Phys Med Rehabil. 2002;81:597-600.
104. Paley D, McMurtry RY. Median nerve compression test in carpal tunnel syndrome diagnosis reproduces signs and symptoms in affected wrist. Orthop Rev. 1985;14:411-415.
105. Palumbo CF, Szabo RM. Examination of patients for carpal tunnel syndrome sensibility, provocative, and motor testing. Hand Clin. 2002;18:269-277, vi.
106. Patel MR, Bassini L. A comparison of five tests for determining hand sensibility. J Reconstr Microsurg. 1999;15:523-526.
107. Pelmear PL, Taylor W. Carpal tunnel syndrome and hand-arm vibration syndrome. A diagnostic enigma. Arch Neurol. 1994;51:416-420.
108. Phalen GS. The birth of a syndrome, or carpal tunnel revisited. J Hand Surg [Am]. 1981;6:109-110.
109. Phalen GS. The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin Orthop. 1972;83:29-40.
110. Phalen GS. The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am. 1966;48:211-228.
111. Phalen GS. Reflections on 21 years' experience with the carpal-tunnel syndrome. JAMA. 1970;212:1365-1367.
112. Raudino F. Tethered median nerve stress test in the diagnosis of carpal tunnel syndrome. Electromyogr Clin Neurophysiol. 2000;40:57-60.
113. Redmond MD, Rivner MH. False positive electrodiagnostic tests in carpal tunnel syndrome. Muscle Nerve. 1988;11:511-518.
114. Rempel D, Evanoff B, Amadio PC, et al. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health. 1998;88:1447-1451.
115. Rendell MS, Katims JJ, Richter R, Rowland F. A comparison of nerve conduction velocities and current perception thresholds as correlates of clinical severity of diabetic sensory neuropathy. J Neurol Neurosurg Psychiatry. 1989;52:502-511.
116. Robinson LR, Micklesen PJ, Wang L. Strategies for analyzing nerve conduction data: superiority of a summary index over single tests. Muscle Nerve. 1998;21:1166-1171.
117. Rosenberg D, Conolley J, Dellon AL. Thenar eminence quantitative sensory testing in the diagnosis of proximal median nerve compression. J Hand Ther. 2001;14:258-265.
118. Rotman MB, Donovan JP. Practical anatomy of the carpal tunnel. Hand Clin. 2002;18:219-230.
119. Sackett DL, Haynes RB. The architecture of diagnostic research. BMJ. 2002;324:539-541.
120. Sackett DL, Straus S. On some clinically useful measures of the accuracy of diagnostic tests. ACP J Club. 1998;129:A17-19.
121. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine. How to Practice and Teach EBM. Toronto, Ontario, Canada: Churchill Livingstone; 2000.
122. Scelsa SN, Herskovitz S, Bieri P, Berger AR. Median mixed and sensory nerve conduction studies in carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol. 1998;109:268-273.
123. Seror P. Tinel's sign in the diagnosis of carpal tunnel syndrome. J Hand Surg [Br]. 1987;12:364-365.
124. Shinya K, Lanzetta M, Conolly WB. Risk and complications in endoscopic carpal tunnel release. J Hand Surg [Br]. 1995;20:222-227.
125. Simpson JA. Electrical signs in the diagnosis of carpal tunnel and related syndromes. J Neurochem. 1956;19:275-280.
126. Skie M, Zeiss J, Ebraheim NA, Jackson WT. Carpal tunnel changes and median nerve compression during wrist flexion and extension seen by magnetic resonance imaging. J Hand Surg [Am]. 1990;15:934-939.
127. Spicher C, Kohut G, Miauton J. At which stage of sensory recovery can a tingling sign be expected? a review and proposal for standardization and grading. J Hand Ther. 1999;12:298-308.
128. Stevens JC. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve. 1997;20:1477-1486.
129. Stevens JC, Sun S, Beard CM, O'Fallon WM, Kurland LT. Carpal tunnel syndrome in Rochester, Minnesota, 1961 to 1980. Neurology. 1988;38:134-138.
130. Strauch B, Lang A. The ten test revisited. Plast Reconstr Surg. 2003;112:593-594.
131. Strauch B, Lang A, Ferder M, Keyes-Ford M, Freeman K, Newstein D. The ten test. Plast Reconstr Surg. 1997;99:1074-1078.
132. Strauch RJ, Michelson H, Rosenwasser MP. Repair of rupture of the distal tendon of the biceps brachii. Review of the literature and report of three cases treated with a single anterior incision and suture anchors. Am J Orthop. 1997;26:151-156.
133. Szabo RM, Gelberman RH, Dimick MP. Sensibility testing in patients with carpal tunnel syndrome. J Bone Joint Surg Am. 1984;66:60-64.
134. Szabo RM, Slater RR, Jr., Farver TB, Stanton DB, Sharman WK. The value of diagnostic testing in carpal tunnel syndrome. J Hand Surg [Am]. 1999;24:704-714.
135. Tassler PL, Dellon AL. Correlation of measurements of pressure perception using the pressure-specified sensory device with electrodiagnostic testing. J Occup Environ Med. 1995;37:862-866.
136. Tetro AM, Evanoff BA, Hollstien SB, Gelberman RH. A new provocative test for carpal tunnel syndrome. Assessment of wrist flexion and nerve compression. J Bone Joint Surg Br. 1998;80:493-498.
137. Thomas PK. Motor nerve conduction in the carpal tunnel syndrome. Neurology. 1960;10:1045-1050.
138. Uncini A, Di Muzio A, Cutarella R, Awad J, Gambi D. Orthodromic median and ulnar fourth digit sensory conductions in mild carpal tunnel syndrome. Neurophysiol Clin. 1990;20:53-61.
139. Uncini A, Lange DJ, Solomon M, Soliven B, Meer J, Lovelace RE. Ring finger testing in carpal tunnel syndrome: a comparative study of diagnostic utility. Muscle Nerve. 1989;12:735-741.
140. van Dijk JG. Multiple tests and diagnostic validity. Muscle Nerve. 1995;18:353-355.
141. van Vliet D, Novak CB, Mackinnon SE. Duration of contact time alters cutaneous pressure threshold measurements. Ann Plast Surg. 1993;31:335-339.
142. Walters C, Rice V. An evaluation of provocative testing in the diagnosis of carpal tunnel syndrome. Mil Med. 2002;167:647-652.
143. Weiss AP, Akelman E. Carpal tunnel syndrome: a review. R J Med. 1992;75:303-306.
144. Werner RA, Albers JW, Franzblau A, Armstrong TJ. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle Nerve. 1994;17:632-636.
145. Werner RA, Franzblau A, Johnston E. Comparison of multiple frequency vibrometry testing and sensory nerve conduction measures in screening for carpal tunnel syndrome in an industrial setting. Am J Phys Med Rehabil. 1995;74:101-106.
146. Werner RA, Franzblau A, Johnston E. Quantitative vibrometry and electrophysiological assessment in screening for carpal tunnel syndrome among industrial workers: a comparison. Arch Phys Med Rehabil. 1994;75:1228-1232.
147. White KM, Congleton JJ, Huchingson RD, Koppa RJ, Pendleton OJ. Vibrometry testing for carpal tunnel syndrome: a longitudinal study of daily variations. Arch Phys Med Rehabil. 1994;75:25-28.
148. Williams TM, Mackinnon SE, Novak CB, McCabe S, Kelly L. Verification of the pressure provocative test in carpal tunnel syndrome. Ann Plast Surg. 1992;29:8-11.
149. Winn FJ, Jr., Habes DJ. Carpal tunnel area as a risk factor for carpal tunnel syndrome. Muscle Nerve. 1990;13:254-258.