Tinel’s Test

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Purpose

Tinel's sign is a way to detect irritated nerves

Technique

It is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or "pins and needles" in the distribution of the nerve. It takes its name from French neurologist Jules Tinel (1879-1952).[1][2][3]
The test is positive when there is pressure neuropathy of the nerve, like in the foot or ankle, or in the hand. When the nerve is not trapt behind a structure there will be a negative test and the patient will feel no pain. On the opposite when the nerve is trapt the patient will feel tingling’s in the distal area. (5)
When the nerve is trapt in the tarsal tunnel the sign can be called by tapping whit a reflex hammer just behind the medial malleolus. (5)


[1]
[2]

Evidence


The tinel’s test is a specific test for the carpal tunnel syndrome and can be used as indication for medical management. (4)
It is concluded that it is difficult to identify patients with tibial nerve compression at the ankle or foot region reliably with traditional electrodiagnostic techniques, even in the absence of neuropathy, and that the presence of a positive "Tinel" sign over the tibial nerve in the tarsal tunnel can identify this as a site of chronic nerve compression. (5)

Resources

Pubmed, medline

References

  1. Physiotutors. Tinel's Sign (Ankle)⎟Peripheral Nerve Injury. Available from: https://www.youtube.com/watch?v=sAhEhWYmkEQ
  2. Physiotutors. Tinel Sign: Wrist⎟Carpal Tunnel Syndrome. Available from: https://www.youtube.com/watch?v=U8cPjPeZgFw

1. Tinel, J., Nerve wounds. London: Baillère, Tindall and Cox, 1917 (C)

2. Tinel, J. (1915) Le signe du fourmillement dans les lésions des nerfs périphériques. Presse médicale, 47, 388-389 (B)
3. Tinel, J. (1978) The "tingling sign" in peripheral nerve lesions (Translated by EB Kaplan). In: M. Spinner M (Ed.), Injuries to the Major Branches of Peripheral Nerves of the Forearm. (2nd ed.) (pp 8-13). Philadelphia: WD Saunders Co (B)

4. Clinical diagnosis of carpal tunnel syndrome: old tests-new concepts. El Miedany Y, Ashour S, Youssef S, Mehanna A, Meky FA. Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt. (A)

5. Dellon AL. | The four medial ankle tunnels: a critical review of perceptions of tarsal tunnel syndrome and neuropathy. | Neurosurg Clin N Am. | 2008 Oct;19(4):629-48, vii. (B)