Original Research

Sensitivity of Mixed and Comparative Electrodiagnostic Methods in Diagnosis of Carpal Tunnel Syndrome

Noor Fatima1
King Edward Medical University & Mayo Hospital, Lahore, Pakistan
Safia Bano1
King Edward Medical University & Mayo Hospital, Lahore, Pakistan
Mohsin Zaheer2
Lahore General Hospital, Lahore
Ahmad Nawaz3
Graduate School of Medicine, Kyoto University, Japan
Ahsan Numan1
King Edward Medical University & Mayo Hospital, Lahore, Pakistan

✉ Correspondence: Noor Fatima Email: noorf9425@gmail.com

DOI https://doi.org/10.70302/jpsim.v7i3.2641
Volume: 7, Issue 3 Pages: 213–218 Published: 21 Aug 2026
Received: 23 Dec 2025 Revised: 29 May 2026 Accepted: 12 Aug 2026 Published Online: 21 Aug 2026

Abstract

Objectives

Carpal Tunnel Syndrome is a prevalent mononeuropathy caused by compression of the median nerve at the wrist. Early and accurate diagnosis is critical to prevent progressive nerve damage and optimize patient outcomes. This study compared the sensitivity of mixed and comparative electrodiagnostic methods in diagnosing Carpal Tunnel Syndrome, particularly in early stages, to enhance diagnostic accuracy and guide management strategies.

Methods

The comparative assessment between Median and Ulnar nerves in the Lumbrical Interossei muscles demonstrated the highest sensitivity (84.8%), followed by the Median-Ulnar fourth digit comparison (75.0%) and the Median versus Radial Digit One study (69.1%). Mixed palmar and segmental studies had lower sensitivity (61.3% and 51.9%, respectively). Conventional methods, including median motor and sensory studies, demonstrated limited accuracy (53% to 57%). Females were predominant (2.3:1 ratio), and 75% of patients had bilateral symptoms.

Results

Among all techniques evaluated, the Median-Ulnar Lumbrical Interossei comparison demonstrated the highest sensitivity (84.8%), followed by the Median-Ulnar fourth digit comparison (75.0%) and the Median versus Radial Digit One study (69.1%). In contrast, the mixed palmar study and segmental study showed lower sensitivity (61.3% and 51.9%, respectively). Conventional electrodiagnostic approaches, including median motor and sensory studies, had limited diagnostic accuracy (53% to 57%). Females were predominate (2.3:1), and bilateral symptoms were observed in 75% of the patients.

Conclusion

Conventional electrodiagnostic approaches have limited sensitivity in diagnosing carpal tunnel syndrome, particularly in cases of mild-to-moderate severity. Comparative studies, such as the Median versus Ulnar Lumbrical Interossei and Median versus Ulnar Digit Four studies, significantly improve diagnostic accuracy. Integrating these advanced methods into routine protocols is essential to minimize false-negative results and enhance early detection.

Keywords
Carpal Tunnel Syndrome (CTS) Electrodiagnosis Comparative Studies Diagnostic Sensitivity

How to Cite This Article

Fatima N, Bano S, Zaheer M, Nawaz A, Numan A. Sensitivity of Mixed and Comparative Electrodiagnostic Methods in Diagnosis of Carpal Tunnel Syndrome. J Pak Soc Intern Med. 2026;7(3):213–218. doi:10.70302/jpsim.v7i3.2641

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Conflict of Interest

The authors declare no conflict of interest.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

This research received no specific grant from any funding agency.

Funder information follows the Crossref Funder Registry standard.

Ethics Statement

not_applicable

Conducted in accordance with the Declaration of Helsinki.

References

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2026 Journal of Pakistan Society of Internal Medicine.
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