Musculoskeletal

Question 1

Carpal Tunnel Syndrome

Think CAMPT

Answer 1

Cause - median nerve compression

Symptoms

• pins and needles in thumb, and index and middle finger
• numbness of thumb abductor - abductor pollis brevis (median nerve innovates this)
• wasting of thenar eminence

Tests
Tinel’s sign: tapping causes paraesthesia
Phalen’s sign: flexion of wrist causes symptoms (because compressing the nerve more)

Treatment
corticosteroid injection
wrist splints at night
surgical decompression (flexor retinaculum division)

C- corticosteroid 
A - 
M - medial nerve compression 
P - phalens sign 
T - tinels sign + wasting of thenar eminence

Question 2

Vertigo Differential diagnosis

• How to differentiate between central and peripheral
• 3 main peripheral causes

Answer 2

Central - HINTs test (DANISH) -cerebellar stroke
-CT

Peripheral
BPPV
Minners
Vestibular neuronitis