Carpal tunnel syndrome Flashcards
What is carpal tunnel syndrome?
Compression of the medial nerve within the carpal tunnel of the wrist due to the raised pressure within the compartment
What are the clinical features for carpal tunnel?
pain, numbness, paraesthesia, throughout the median nerve sensory distribution
Why is the palm usually spared in carpal tunnel syndrome?
due to palmar cutaneous branch of the median nerve branching proximal to the flexor retinaculum and passing over the carpal tunnel
What are the risk factors for carpal tunnel?
Female, increasing age, pregnancy, obesity, previous injury, diabetes mellitus, RA, hypothyroidism, repetitive hand or wrist movements
When are symptoms of carpal tunnel usually worse?
At night
How can symptoms of carpal tunnel be relieved?
hanging your arm over the side of the bed or shaking it back and forth
How can the median nerve be examined?
Tinels test- percussing and seeing if electric shocks are felt, or Phalens test- holding the wrist in full flexion for a minute
What may be present in later stages of carpal tunnel syndrome?
Weakness of thumb abduction due to denervation atrophy of the thenar muscles, wasting of the thenar eminence
What are the differential diagnosis of carpal tunnel syndrome?
Carvical radiculopathy, pronator teres syndrome, flexor carpi radialis tenosynovitis
What investigations would be done for carpal tunnel syndrome?
clinical diagnosis however nerve conduction studies can be done
What is the management for carpal tunnel syndrome?
wrist splint, corticosteroid injections, NSAIDs, carpal tunnel release surgery
What are the complications of carpal tunnel syndrome surgery?
persistant CTS symptoms, infection, scar formation, nerve damage, trigger thumb
What is a longterm untreated CTS risks?
Neurological impairment
