False positive rate of thoracic outlet syndrome diagnostic maneuvers

K. M. Nord, P. Kapoor, J. Fisher, G. Thomas, A. Sundaram, K. Scott, M. J. Kothari

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: In this study, we aim to determine the false-positive rate & specificity in normal subjects and carpal tunnel syndrome (CTS) patients of five provocative maneuvers used to diagnose thoracic outlet syndrome (TOS). Design/Methods: We prospectively evaluated subjects with clinical and electrophysiological evidence of CTS as well as normal subjects. All subjects underwent provocative testing by a blinded physician, which included the Adson A & B tests, Costoclavicular maneuver (CCM), Elevated arm stress test (Roos), and Supraclavicular pressure (SCP). Results: In the CTS group, false positive tests were observed in 42% in the Adson A test, 45% in the Adson B test, 48% in the CCM, 77% in the Roos test, and 61% in the SCP. 94% of the CTS patients had at least 1 positive TOS diagnostic maneuver. In the normal group, false positive tests were observed in 9% in the Adson A test, 20% in the Adson B test, 16% in the CCM, 47% in the Roos test, and 30% in the SCP. 56% of the normal patients had at least 1 positive TOS diagnostic maneuver. Conclusions: We conclude that current provocative maneuvers used to diagnose TOS result in a high false-positive rate in normal subjects and an even higher false-positive rate in CTS patients.

Original languageEnglish (US)
Pages (from-to)67-74
Number of pages8
JournalElectromyography and Clinical Neurophysiology
Volume48
Issue number2
StatePublished - Mar 1 2008

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Thoracic Outlet Syndrome
Carpal Tunnel Syndrome
Pressure
Exercise Test
Physicians

All Science Journal Classification (ASJC) codes

  • Physiology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Nord, K. M., Kapoor, P., Fisher, J., Thomas, G., Sundaram, A., Scott, K., & Kothari, M. J. (2008). False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyography and Clinical Neurophysiology, 48(2), 67-74.
Nord, K. M. ; Kapoor, P. ; Fisher, J. ; Thomas, G. ; Sundaram, A. ; Scott, K. ; Kothari, M. J. / False positive rate of thoracic outlet syndrome diagnostic maneuvers. In: Electromyography and Clinical Neurophysiology. 2008 ; Vol. 48, No. 2. pp. 67-74.
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Nord, KM, Kapoor, P, Fisher, J, Thomas, G, Sundaram, A, Scott, K & Kothari, MJ 2008, 'False positive rate of thoracic outlet syndrome diagnostic maneuvers', Electromyography and Clinical Neurophysiology, vol. 48, no. 2, pp. 67-74.

False positive rate of thoracic outlet syndrome diagnostic maneuvers. / Nord, K. M.; Kapoor, P.; Fisher, J.; Thomas, G.; Sundaram, A.; Scott, K.; Kothari, M. J.

In: Electromyography and Clinical Neurophysiology, Vol. 48, No. 2, 01.03.2008, p. 67-74.

Research output: Contribution to journalArticle

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Nord KM, Kapoor P, Fisher J, Thomas G, Sundaram A, Scott K et al. False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyography and Clinical Neurophysiology. 2008 Mar 1;48(2):67-74.