Tinel's sign

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Tinel's sign is a clinical test used by medical professionals to detect irritated nerves. It is named after the French neurologist Jules Tinel, who first described the sign in 1915. Tinel's sign is commonly used in the diagnosis of carpal tunnel syndrome, cubital tunnel syndrome, and other nerve compression syndromes.

Procedure[edit | edit source]

To perform Tinel's sign, the examiner taps lightly over the course of a nerve, usually at a site of potential nerve compression or injury. A positive Tinel's sign is indicated by a tingling sensation or "pins and needles" feeling in the distribution of the nerve. This sensation is often described as similar to an electric shock.

Clinical Significance[edit | edit source]

Tinel's sign is particularly useful in diagnosing conditions such as:

Carpal tunnel syndrome: Tapping over the median nerve at the wrist.
Cubital tunnel syndrome: Tapping over the ulnar nerve at the elbow.
Tarsal tunnel syndrome: Tapping over the posterior tibial nerve at the ankle.

A positive Tinel's sign suggests that the nerve is regenerating or that there is ongoing nerve irritation. However, it is not a definitive test and should be used in conjunction with other diagnostic methods such as nerve conduction studies and electromyography.

History[edit | edit source]

The sign was first described by Jules Tinel in 1915 in the context of nerve injuries sustained during World War I. Tinel observed that tapping over a regenerating nerve produced a tingling sensation in the distribution of the nerve, which he termed "la signe de fourmillement."

Limitations[edit | edit source]

While Tinel's sign can be a useful diagnostic tool, it has limitations. The test is subjective and relies on the patient's description of the sensation. Additionally, a positive Tinel's sign can occur in healthy individuals, and a negative sign does not rule out nerve pathology. Therefore, it should be used as part of a comprehensive clinical evaluation.