Signs and Evidence

Making clinical sense of scientific data


Beware of the limitations of this tool

Hand and wrist

Choose the relevant clinical signs you want to include in the calculation of posttest probabilities. The strongest signs are listed the highest.

1Ulnar nerve compression
2Closed fist sign
3Hypalgesia in median nerve territory
4Nocturnal paresthesia
5WHAT test
6Tinel's test
7Eichhoff's test

To further investigations

Select the conditions you want to compare

Pretest probabilities will be calculated based on averages from relevant studies.

 Select or deselect all boxes

Working population
All adults
All adults

Sources used:

1.Christopher A et al. Does This Patient Have Carpal Tunnel Syndrome? JAMA. 2000;283(23):3110-3117
2.Goubau JF et al. The wrist hyperflexion and abduction of the thumb (WHAT) test: a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff’s Test. The Journal of Hand Surgery (European Volume) 2014, Vol. 39E(3) 286 –292
3.Beekman R et al. The diagnostic value of provocative clinical tests in ulnar neuropathy at the elbow is marginal. J Neurol Neurosurg Psychiatry. 2009 Dec;80(12):1369-74
4.Novak CB et al. Provocative testing for cubital tunnel syndrome. J Hand Surg (AM) 1994 September; 19(5):817-20
5.Kuhlman K et al. Sensitivity and specificity of carpal tunnel syndrome signs. American Journal of Physical Medicine & Rehabilitation. 76(6):451-457, nov 1997
6.Fowler JR et al. The Sensitivity and Specificity of Ultrasound for the Diagnosis of Carpal Tunnel Syndrome: A Meta-analysis. Clin Orthop Relat Res. 2011 Apr; 469(4): 1089–1094
7.Atroshi I et al. Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome. BMC Musculoskelet Disord. 2003; 4: 9
8.Lee KH et al. Ultrasonographic evaluation of the first extensor compartment of the wrist in de Quervain’s disease. Journal of Orthopaedic Science Volume 19, Issue 1, January 2014, Pages 49-54
9.Dale AM et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013 Sep 1; 39(5): 495–505
10.Atroshi I et al. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153–158
11.Adachi S et al. Prevalence of de Quervain's Disease in the General Population and Risk Factors. The Kitakanto Medical Journal. 2011. 61. 479-482.
12.Khedr et al. Prevalence of Common Types of Compression Neuropathies in Qena Governorate/Egypt: A Population-Based Survey. Neuroepidemiology 2016;46:253-260