Durkan's test

Durkan's Test, also known as the Carpal Compression Test, is a clinical diagnostic procedure used to identify Carpal Tunnel Syndrome (CTS). This condition is characterized by the compression of the median nerve as it travels through the carpal tunnel in the wrist, leading to symptoms such as numbness, tingling, and weakness in the hand and fingers. Durkan's Test is a simple, non-invasive method that can be performed in a clinical setting to help diagnose CTS.

Procedure

The test is conducted by applying direct pressure over the carpal tunnel and median nerve at the wrist for a duration of 30 seconds. The examiner uses their thumbs to exert pressure in a perpendicular fashion over the patient's carpal tunnel. The development of symptomatic tingling or numbness in the distribution of the median nerve during this time is considered a positive Durkan's Test. This indicates the likelihood of Carpal Tunnel Syndrome.

Interpretation

A positive Durkan's Test suggests the presence of Carpal Tunnel Syndrome. However, it is important to note that while a positive test indicates the likelihood of CTS, it is not definitive. Further diagnostic testing, such as electromyography (EMG) and nerve conduction studies, may be required to confirm the diagnosis. Conversely, a negative Durkan's Test does not entirely rule out CTS, especially in cases where clinical symptoms suggest otherwise.

Advantages

Durkan's Test is valued for its simplicity and non-invasive nature. It does not require any specialized equipment and can be quickly performed in a clinical setting. Additionally, it has been reported to have a higher specificity and sensitivity compared to other physical examination tests for CTS, such as the Tinel's sign and Phalen's maneuver.

Limitations

Despite its advantages, Durkan's Test is not without limitations. The test's accuracy can be influenced by the examiner's technique and the patient's individual threshold for pain and discomfort. False positives can occur in individuals without CTS, and false negatives may be seen in early or mild cases of the syndrome.

Conclusion

Durkan's Test is a valuable tool in the clinical assessment of Carpal Tunnel Syndrome. Its ease of use and non-invasive nature make it a preferred initial diagnostic test. However, it should be used in conjunction with a thorough clinical examination and, if necessary, further diagnostic testing to confirm the presence of CTS.