Carpal Tunnel syndrome

Question 1

Name ‘conditions’ that place individuals at risk of developing carpal tunnel syndrome

Answer 1

TADOOP

Pregnancy
Obesity
Hypothyroidism
Trauma 
OA
Diabetes
Acromegaly

Question 2

How is carpal tunnel syndrome treated?

Answer 2

1. Surgical decompression
2. Steroid injections
3. Splints and stretching (and weight loss)

Question 3

What is the condition meralgia paresthetica characterized by and what causes it? Which population commonly experiences this

Answer 3

Tingling, numbness and burning pain in the outer thigh caused by compression to the lateral femoral cutaneous nerve

Commonly experienced by pregnant women due to enlarged fetus and accumulated tissue fluid

Question 4

What is the common presentation of shingles and what causes it?

Answer 4

Caused by the varicella-zoster virus which damages a particular nerve (Therefore, it is a peripheral neuropathy) causing a painful band shaped rash that commonly affects 1-2 adjacent dermatomes

Question 5

How would you approach a patient with carpal tunnel syndrome from an examination perspective?

Answer 5

1. Check functions of median nerve: motor thumb opposition
2. Sensory: lateral aspect of palm (first 3 fingers)
3. Tinel’s sign and phalen’s test

Question 6

If a GP notices muscle wasting or weakness at the first appointment, why might this lead to a more urgent referral to a hand surgeon?

Answer 6

As this indicates that the nerve is being compressed to the point of damage (limited blood supply) and the innervated muscles are becoming weak/wasting; therefore requiring more urgent decompression to save nerve function