Hoffmann tinel test overview

The Hoffmann-Tinel test is a diagnostic procedure used to assess nerve regeneration or the presence of nerve irritation or damage.

It is commonly performed in patients suspected of having conditions like carpal tunnel syndrome or other forms of peripheral neuropathy.

Purpose of Hoffmann tinel test

• Detects nerve irritation.
• Assesses the regeneration of nerves following an injury or surgical repair.
• Commonly used for conditions involving peripheral nerves, such as:
  • Carpal tunnel syndrome (median nerve compression).
  • Ulnar nerve entrapment.
  • Post-traumatic or post-surgical nerve recovery.

Hoffmann tinel test Procedure

1. The patient is typically seated or lying down.The affected limb is positioned comfortably.
2. The clinician taps gently along the course of the suspected nerve at specific points, such as:
   • The wrist for the median nerve (carpal tunnel syndrome).
   • The elbow for the ulnar nerve.
   • The tapping is performed using a reflex hammer or fingertips.
3. The patient is asked to describe any sensations felt during the tapping.

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Interpretation of Results

• Positive Hoffmann-Tinel Test:
  • A tingling or “pins-and-needles” sensation (paresthesia) radiates along the path of the nerve.
  • This indicates nerve irritation or regeneration.
• Negative Hoffmann-Tinel Test:
  • No abnormal sensations are reported.
  • May suggest no nerve compression or that the nerve damage is not in the area being tested.

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Common Applications Hoffmann tinel test

1. Carpal Tunnel Syndrome:
   • Tapping over the carpal tunnel (on the palmar aspect of the wrist) elicits tingling in the thumb, index, middle, and ring fingers.
2. Ulnar Nerve Entrapment:
   • Tapping at the elbow (cubital tunnel) produces tingling in the ring and little fingers.
3. Post-Injury Nerve Recovery:
   • Helps monitor nerve regeneration, as a positive test may indicate growing nerve fibers.

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Limitations of test

• Hoffmann tinel test isn’t specific to any one condition.
• It may produce false positives or negatives depending on:
  • The patient’s sensitivity.
  • The skill of the examiner.
  • Variability in nerve anatomy.
• Best used in conjunction with other diagnostic methods (e.g., nerve conduction studies, electromyography).

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