Diagnostic test accuracy of Tinel’s test in adults with carpal tunnel syndrome—a systematic review

Sivashnie Gopal, Catherine Minns Lowe, Binoy Kumaran

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Tinel’s test is commonly used in the diagnosis of carpal tunnel syndrome (CTS) despite its questionable diagnostic test accuracy (DTA). This systematic review investigated the DTA of Tinel’s test in CTS using electrodiagnosis as the reference standard and explored the heterogeneity between included studies. Methods: Prospective studies evaluating Tinel’s test in adults with CTS were included. The principal measures were sensitivity and specificity. A literature search was conducted for studies published up to 7 June 2024. The methodological quality was assessed using the QUADAS-2 tool. Narrative synthesis of study results and heterogeneity was undertaken. Meta-analysis was not conducted due to the high variability in diagnostic thresholds. Results: Fifteen out of 4099 identified studies met the inclusion criteria. Patient selection scored ‘high’ in risk of bias and applicability concerns. Examiner blinding was poorly reported. Sensitivity varied from 30 to 89%. Specificity varied from 41 to 100%. Heterogeneity was found across all studies in participant selection criteria, Tinel’s test performance, electrodiagnostic criteria, and diagnostic thresholds. Conclusions: Tinel’s test demonstrated variable diagnostic accuracy in CTS. Due to poor methodological quality and high variability among the studies, more DTA studies are necessary. PROSPERO Protocol number: CRD42020218165 dated 27 November 2020.

Original languageEnglish
Article number2411178
Pages (from-to)1-12
Number of pages12
JournalPhysical Therapy Reviews
Early online date9 Oct 2024
DOIs
Publication statusE-pub ahead of print - 9 Oct 2024

Keywords

  • Carpal tunnel syndrome
  • Tinel’s test
  • diagnostic test accuracy
  • median nerve

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