Which physical examination signs are commonly positive in Carpal Tunnel Syndrome?

Which physical examination signs are commonly positive in Carpal Tunnel Syndrome?

• A. Phalen's sign and Tinel's sign
• B. Romberg test
• C. Homan's sign
• D. Babinski sign

Answer: (A)

Carpal Tunnel Syndrome is a compression of the median nerve at the wrist, so tests that provoke median nerve symptoms are the most informative. Phalen's maneuver—holding the wrists in full flexion to reproduce symptoms—often yields numbness or tingling in the median nerve distribution. Tinel's sign—tapping over the carpal tunnel to elicit paresthesias—can also reproduce these symptoms. These findings are commonly positive in CTS because they directly stress the affected nerve at the site of compression. In contrast, the Romberg test assesses proprioception and balance, Homan's sign relates to deep vein thrombosis, and the Babinski sign indicates an upper motor neuron lesion; none of these specifically evaluate median nerve compression at the wrist.

Carpal Tunnel Syndrome is a compression of the median nerve at the wrist, so tests that provoke median nerve symptoms are the most informative. Phalen's maneuver—holding the wrists in full flexion to reproduce symptoms—often yields numbness or tingling in the median nerve distribution. Tinel's sign—tapping over the carpal tunnel to elicit paresthesias—can also reproduce these symptoms. These findings are commonly positive in CTS because they directly stress the affected nerve at the site of compression. In contrast, the Romberg test assesses proprioception and balance, Homan's sign relates to deep vein thrombosis, and the Babinski sign indicates an upper motor neuron lesion; none of these specifically evaluate median nerve compression at the wrist.