Background and Objective: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy with involvement of median nerve. Patients with this syndrome refer for pain and paresthesia in hand that leads to thenar muscles atrophy. Diagnosis of CTS is made by history, physical examination and electrophysiological study. Recently, Volar Hot Dog (VHD) sign has been proposed for diagnosis of this disease. Thus, we studied VHD as a diagnostic tool in CTS patients according to evidence based medicine. Materials and Methods: In 50 patients referred for pain and paresthesia in median nerve area in hand, a diagnosis of CTS was made by NIOSH criteria and 50 control subjects were also examined for this sign. Results: The sensitivity of VHD was 0.84, the specificity of VHD was 0.32, the accuracy of the test was 0.58 and pretest probability of the disease was 0.5 and post-test probability of the disease with a positive result was 0.55 and post-test probability of the disease with a negative result was 0.35. Meanwhile, positive likely ratio (LR+) was 1.23 and negative likely ratio (LR-) was 0.5. Conclusion: VHD sign (test) had a higher sensitivity than Hoffman-Tinel and Phalen tests with a lower specificity of the test with LR+ 1.2 and LR- 0.5 and this test is a poor to fair test for diagnosis of CTS and will be mainly valuable for screening of the syndrome.
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