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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel.
  • The carpal tunnel is the area bound by the carpal bones and the transverse carpal ligament.
  • The median nerve, flexor digitorum profundus, flexor digitorum superficialis (FDS), and flexor pollicis longus are located in the carpal tunnel.
  • Carpal tunnel syndrome can be classified as acute or chronic.

Etiology

  • Acute:
    • Trauma
    • Infection
    • Snake bite
    • Hemorrhage
    • High-pressure injection injury
  • Chronic:
    • Occupational/overuse syndromes—high impact, repetitive motion
    • Pregnancy, birth control pills
    • Granulomatous disease: Tuberculosis, sarcoidosis
    • Mass lesions with median nerve compression
    • Osteophytes
    • Amyloid
    • Multiple myeloma
    • Rheumatoid arthritis
    • Endocrine disorders: Hypothyroidism, diabetes mellitus, acromegaly
    • Chronic hemodialysis
    • Idiopathic

Pediatric Considerations
Idiopathic causes are rare in children; most cases have a correctable cause including:
  • Trauma
  • Mucolipidosis
  • Hamartoma of the median nerve
  • Anomalous FDS
  • Hemophilia with hematoma

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Citation

Rosen, Peter, et al., editors. "Carpal Tunnel Syndrome." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307311/all/Carpal_Tunnel_Syndrome.
Carpal Tunnel Syndrome. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307311/all/Carpal_Tunnel_Syndrome. Accessed April 24, 2019.
Carpal Tunnel Syndrome. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307311/all/Carpal_Tunnel_Syndrome
Carpal Tunnel Syndrome [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307311/all/Carpal_Tunnel_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Carpal Tunnel Syndrome ID - 307311 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307311/all/Carpal_Tunnel_Syndrome PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -