Carpal Tunnel

Question 1

Common cause of bilateral carpal tunnel syndrome

Answer 1

Rheumatoid arthritis is a common cause of bilateral carpal tunnel syndrome

Question 2

Carpal Tunnel Examination findings

Answer 2

weakness of thumb abduction (abductor pollicis brevis)

wasting of thenar eminence (NOT hypothenar)

Tinel’s sign: tapping causes paraesthesia

Phalen’s sign: flexion of wrist causes symptoms

Question 3

Mild to Moderate treatment of Carpal Tunnel

Answer 3

6-week trial of conservative treatments if the symptoms are mild-moderate

corticosteroid injection

wrist splints at night: particularly useful if transient factors present e.g. pregnancy