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Carpal tunnel syndrome - Coggle Diagram
Carpal tunnel syndrome
Definition
Compression of the Median Nerve within the Carpal Tunnel at the Wrist
Investigations
Nerve conduction study (gold standard)
EMG
Ultrasound (median nerve swelling)
MRI (if atypical or secondary causes)
Etiology
Repetitive wrist movements
Pregnancy
Diabetes mellitus
Hypothyroidism
Rheumatoid arthritis
Obesity
Wrist trauma
Pathophysiology
Pressure increase in carpal tunnel
Decrease in Median nerve blood flow
leading to Nerve ischemia
Leading to Sensory + motor dysfunction
Clinical Features
Sensory
Numbness & tingling in
Thumb
Index finger
Middle finger
Radial half of ring finger
Worse at night
Motor
Weak thumb opposition
Difficulty gripping objects
Thenar muscle atrophy (late)
Physical Examination
Phalen test → wrist flexion reproduces symptoms
inel sign → tapping over carpal tunnel causes tingling
Decreased two-point discrimination
Weak abductor pollicis brevis
Management
Conservative
Wrist splint (neutral position)
NSAIDs
Activity modification
Corticosteroid injection
Surgical
Carpal tunnel release
Indicated if:
Thenar atrophy
Persistent symptoms
Failed conservative treatment
Complications
Permanent median nerve damage
Irreversible thenar atrophy
Chronic hand weakness