VALIDITY OF SPHYGMOMANOMETER TEST COMPARED TO DURKAN AND PHALEN TESTS IN DIAGNOSIS OF CARPAL TUNNEL SYNDROME WITH NERVE CONDUCTION STUDY CORRELATION. A PROSPECTIVE CROSS SECTIONAL ANALYTICAL STUDY

Background: Carpal Tunnel Syndrome (CTS) is primarily diagnosed through clinical history and provocative physical examination, with confirmation by nerve conduction studies (NCS). Among bedside tests, Phalen’s wrist-flexion maneuver and Durkan’s carpal compression test are most frequently used. The sphygmomanometer (arm cuff) test has been proposed as a standardized, pressure-controlled alternative that utilizes readily available clinical equipment. Aim: To evaluate the diagnostic performance of a standardized sphygmomanometer test in CTS and to determine its sensitivity, specificity, and clinical validity compared with established provocative tests, assessing its potential role as an adjunct in routine evaluation. Methods: This prospective cross-sectional analytical study included 50 female patients (73 symptomatic hands) with clinically suspected CTS. All participants underwent three provocative tests: sphygmomanometer test, Durkan’s carpal compression test, and Phalen’s wrist-flexion test. Nerve conduction studies were subsequently performed as the reference standard. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each clinical test. Results: The sphygmomanometer test demonstrated a sensitivity of 86.2% and specificity of 75.0%. The positive predictive value was 96.6%, while the negative predictive value was 40.0%. Overall, its diagnostic performance was comparable to that of Durkan’s and Phalen’s tests. Conclusion: The sphygmomanometer test provides diagnostic accuracy similar to established provocative maneuvers. It is simple, inexpensive, standardized, and easily applicable in outpatient settings, making it a useful adjunctive tool, particularly in resource-limited environments where immediate access to NCS is unavailable.