Article

In 1953, Gilliatt and Wilson described the pneumatic-tourniquet test
to diagnose the carpal tunnel syndrome (CTS). It was originally carried out by
inflating a brachial cuff at suprasystolic pressure, looking for the appearance
of dysesthesiae; several authors later proposed to perform it at infrasystolic
pressure, arguing that it would better reflect the elevated venous pressure
supposed to be present in CTS. The purpose of this study was to compare both
methods. METHODS: This prospective randomized controlled study included 49
patients and compared both methods to perform Gilliatt's test with more commonly
used provocative tests (Tinel, Phalen, Durkan, and Weber). The following
end-points were considered: typical clinical presentation, altered
neurophysiological tests, abnormal ultrasound findings and early resolution of
symptoms after surgical decompression. RESULTS: For all these end-points, no
significant difference was observed in sensibility nor specificity, whether
Gilliatt's test was performed supra- or infra-systolic. In addition, Gilliatt's
test proved to have less diagnostic value than Phalen and Durkan tests for
sensibility. CONCLUSION: This study did not permit to distinguish the two
versions of Gilliatt's test but to open a discussion about the utility of such a
test to diagnose the CTS.
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Langue : ANGLAIS