Tinel's test of the hand/wrist is performed by tapping which area?

• A. Median nerve over volar aspect of the wrist
• B. Ulnar nerve over the elbow
• C. Radial nerve over the dorsal wrist
• D. Axillary nerve over the proximal arm

Answer: (A)

Tinel's sign in the hand/wrist is about provoking irritation of a nerve by tapping along its course. At the wrist, tapping over the volar aspect where the median nerve travels through the carpal tunnel will reproduce tingling or paresthesias in the median-nerve distribution (thumb, index, middle, and the radial half of the ring finger) if the nerve is irritated, as in carpal tunnel syndrome. This localized tapping targets the site of compression and the nerve involved.

Tapping elsewhere tests different nerves or sites: tapping the ulnar nerve at the elbow would provoke symptoms in the ulnar distribution (little finger and ulnar half of the ring finger) if cubital tunnel pathology were present; tapping the radial nerve at the dorsal wrist would relate to the radial sensory distribution, not the classic median-nerve carpal tunnel presentation; tapping the axillary nerve at the proximal arm would affect the deltoid region, not the hand/wrist.