Diferencia entre revisiones de «Carpal tunnel syndrome»

(Created page with "==Background== *Most common focal mononeuropathy *Results from compression of median nerve at wrist where it traverses the carpal tunnel *Etiology: **Repetitive use, DM, amyloido...")
 
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*Results from compression of median nerve at wrist where it traverses the carpal tunnel
*Results from compression of median nerve at wrist where it traverses the carpal tunnel
*Etiology:
*Etiology:
**Repetitive use, DM, amyloidosis, trauma, edema
**Repetitive wrist flexion/extension, DM, amyloidosis, trauma, edema


==Clinical Features==
==Clinical Features==
*Pain, paresthesia, and numbness in distribution of median nerve
*Pain, paresthesia, and numbness in distribution of median nerve
**Palmar aspect of thumb, index, middle, and radial aspect of ring finger
**Palmar aspect of thumb, index, middle, and radial aspect of ring finger
*Awakening at night w/ burning pain and tingling in hand
*Tinel sign
*Tinel sign
**Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
**Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
*Phalen maneuver
*Phalen maneuver
**Holding wrists in flexion for 60s evokes or worsens symptoms
**Holding wrists in flexion for 60 seconds evokes or worsens symptoms


==Treatment==
==Treatment==

Revisión del 21:29 26 feb 2012

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

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)

Source

Tintinalli