Hand-held nerve conduction device in carpal tunnel syndrome: a prospective study.

Introduction: We assessed the clinical impact of replacing standard neurophysiologic testing with a hand-held device (Mediracer) for diagnosis of carpal tunnel syndrome (CTS).

Methods: One hundred patients (200 hands) with suspected CTS were studied by blinded assessors [Hand-therapist (HT)1 and Consultant Neurophysiologist] using the Mediracer, followed by standard neurophysiologic testing. To simulate testing by personnel without neurological training, Mediracer recordings were analyzed separately by an assessor who had not seen the patients (HT2).

Results: Correlation of the CTS grades was 0.94 for the results obtained by HT1, and 0.87 for HT2. The sensitivity and specificity of the Mediracer was 0.85 and 0.9, respectively, by HT1, and 0.84 and 0.89 for HT2. Nine patients had conditions other than CTS, and 35 patients were judged to require further investigation.

Conclusions: The Mediracer should only be used in patients with typical CTS symptoms and signs and no muscle wasting who have had careful neurological assessment.