Difference between revisions of "Carpal tunnel syndrome"

(Added Durkan sign)
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*Durkan sign (more sensitive)
 
*Durkan sign (more sensitive)
 
**Manual compression of carpal tunnel reproduces symptoms
 
**Manual compression of carpal tunnel reproduces symptoms
 +
 +
==Differential Diagnosis==
  
 
==Treatment==
 
==Treatment==
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#NSAIDs (although not clearly effective)
 
#NSAIDs (although not clearly effective)
 
#Diuretics (if edema is significant contributor to pt's symptoms)
 
#Diuretics (if edema is significant contributor to pt's symptoms)
 +
 +
==See Also==
  
 
==Source==
 
==Source==

Revision as of 22:34, 11 February 2015

Background

  • Most common focal mononeuropathy
  • Results from compression of median nerve at wrist where it traverses the carpal tunnel
  • Etiology:
    • Repetitive wrist flexion/extension, DM, amyloidosis, trauma, edema

Clinical Features

  • Pain, paresthesia, and numbness in distribution of median nerve
    • Palmar aspect of thumb, index, middle, and radial aspect of ring finger
  • Awakening at night w/ burning pain and tingling in hand
  • Tinel sign
    • Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
  • Phalen maneuver
    • Holding wrists in flexion for 60 seconds evokes or worsens symptoms
  • Durkan sign (more sensitive)
    • Manual compression of carpal tunnel reproduces symptoms

Differential Diagnosis

Treatment

  1. Behavioral modification
  2. Wrist splint w/ wrist in neutral position
  3. NSAIDs (although not clearly effective)
  4. Diuretics (if edema is significant contributor to pt's symptoms)

See Also

Source

Tintinalli