Abstract:The incidence and the aetiology of chronic carpal tunnel syndrome in black South Africans was evaluated. This study showed that the incidence of idiopathic carpal tunnel syndrome was very low in this population group and that most patients who presented with symptoms and signs of chronic carpal tunnel syndrome had a specific pathology. A rare case of tumoral calcinosis causing carpal tunnel syndrome is presented. A case of perineural lipofibroma causing carpal tunnel syndrome is also described.
“…Histological sections showed calcified deposits encased in a fibrocartilaginous tissue with inflammatory infiltrates composed of giant cell granulomas. These findings supported the diagnosis of tumoral calcinosis [ 6 , 7 ]. Fig.…”
Section: Case Presentationsupporting
confidence: 82%
“…Regarding the primary type, which is the case in our patient, no associated diseases are thought to be involved; and it is characterized by the presence of a solitary nodule [ 9 ] that appears usually more prevalent among Africans living in tropical or subtropical regions [ 6 , 14 ]. Namba et al pointed that repetitive mechanical traumas to the carpal ligaments, such as in our patient, might be the cause of tumoral calcinosis.…”
Background
Carpal Tunnel Syndrome (CTS) is the most prevalent peripheral nerve entrapment disease. Its pathophysiology is multifactorial and defined as idiopathic in most cases. We present a rare case of CTS secondary to tumoral calcinosis and then searched the English literature to present the details of all published cases with this entity.
Case presentation.
A 52-year-old woman presented for a one-year history of numbness and paresthesia in her right hand. The patient’s signs, symptoms, physical examination, and nerve electrodiagnostic testing suggested median nerve compression at the level of the carpal tunnel. However, a confirmatory magnetic resonance imaging of the wrist showed a localized calcareous lesion in the carpal tunnel. Subsequently, carpal tunnel release and mass excision were successfully performed with no recurrence at a 3-month interval.
Conclusion
CTS secondary to tumoral calcinosis is a rare benign condition. Physicians should remain vigilant and include it in their differential diagnosis when facing a previously healthy patient presenting for chronic CTS symptoms.
“…Histological sections showed calcified deposits encased in a fibrocartilaginous tissue with inflammatory infiltrates composed of giant cell granulomas. These findings supported the diagnosis of tumoral calcinosis [ 6 , 7 ]. Fig.…”
Section: Case Presentationsupporting
confidence: 82%
“…Regarding the primary type, which is the case in our patient, no associated diseases are thought to be involved; and it is characterized by the presence of a solitary nodule [ 9 ] that appears usually more prevalent among Africans living in tropical or subtropical regions [ 6 , 14 ]. Namba et al pointed that repetitive mechanical traumas to the carpal ligaments, such as in our patient, might be the cause of tumoral calcinosis.…”
Background
Carpal Tunnel Syndrome (CTS) is the most prevalent peripheral nerve entrapment disease. Its pathophysiology is multifactorial and defined as idiopathic in most cases. We present a rare case of CTS secondary to tumoral calcinosis and then searched the English literature to present the details of all published cases with this entity.
Case presentation.
A 52-year-old woman presented for a one-year history of numbness and paresthesia in her right hand. The patient’s signs, symptoms, physical examination, and nerve electrodiagnostic testing suggested median nerve compression at the level of the carpal tunnel. However, a confirmatory magnetic resonance imaging of the wrist showed a localized calcareous lesion in the carpal tunnel. Subsequently, carpal tunnel release and mass excision were successfully performed with no recurrence at a 3-month interval.
Conclusion
CTS secondary to tumoral calcinosis is a rare benign condition. Physicians should remain vigilant and include it in their differential diagnosis when facing a previously healthy patient presenting for chronic CTS symptoms.
“…In the United States, the incidence of CTS is one to three persons per 1000 subjects per year, with a prevalence of 50 cases per 1000 subjects in the general population [2]. In South Africa, CTS most commonly affects White people and appears to be rare in Black South Africans [12]. The rate of CTS is two to three times more common among the White US Navy personnel compared to their black counterparts [13].…”
Carpal tunnel syndrome (CTS) is a common entrapment neuropathy characterized by pain, numbness, and impaired function of the hand due to compression of the median nerve at the level of the wrist. Although CTS can develop from repetitive strain, injury, or medical conditions, there are also congenital and genetic risk factors that can predispose individuals to the condition. With respect to anatomical factors, some individuals are born with a smaller carpal tunnel, which increases their susceptibility to median nerve compression. Variations in specific genes, such as those encoding proteins involved in extracellular matrix remodeling, inflammation, and nerve function, have also been linked to an increased risk for CTS. CTS is associated with a high cost of health care maintenance and loss of work productivity. Therefore, it is vital that primary care physicians fully understand the anatomy, epidemiology, pathophysiology, etiology, and risk factors of CTS, so they can be proactive in prevention, diagnosing, and guiding proper treatment. This integrated review also provides insights into how biological, genetic, environmental, and occupational factors interact with structural elements to determine who is most likely to acquire and suffer from CTS. Keeping health practitioners abreast of all the factors that could impact CTS should go a long way in decreasing the health care and socioeconomic burden of CTS.
“…6 Carpal tunnel syndrome also appears to be rare in certain populations as Goga found that patients who are black and from South Africa showed very low incidence of CTS. 7…”
Section: Introductionmentioning
confidence: 99%
“…6 Carpal tunnel syndrome also appears to be rare in certain populations as Goga found that patients who are Black and from South Africa showed very low incidence of CTS. 7 There are multiple treatment modalities for patients with CTS. These modalities range from surgical decompression to conservative treatments of splinting, corticosteroids, physical therapy, and therapeutic ultrasound.…”
Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. There are multiple treatment modalities for CTS. This study examines both clinical and demographic predictors for initial treatment modality of CTS. Methods: Patients diagnosed with CTS between February 2015 and October 2020 with a hand clinic visit within 6 weeks before treatment were included in our study. Patients completed Patient-Reported Outcomes Measurement Information System Pain Interference, Physical Function, and Depression and had complete data on relevant predictor variables. Primary outcomes were treatment group: (1) injection only; (2) release only; and (3) injection followed by release. Bivariate analyses and multinomial logistic regression was used to identify statistically significant variables and independent predictors associated with the treatment groups, respectively. Results: A total of 1409 patients fit our inclusion criteria. Sex, age, body mass index (BMI), race, ethnicity, Pain Interference, and Depression were statistically significant predictors for treatment group in bivariate analysis ( P < .05). In multivariable analysis, adults older than 65 years were less likely to receive either injection only or injection followed by release (odds ratio [OR]: 0.56 and OR: 0.52, respectively; P < .01). Overweight (BMI: ≥25) individuals were less likely to receive injection only (OR: 0.45; P < .01). Women were more likely to have either injection only or injection followed by released (OR: 1.50 and 1.55; P < .01). Similarly, black, Indigenous, or Persons of Color had an increased odds of injection only and injection followed by release (OR: 1.61 and OR: 1.69, respectively; P < .05). Conclusions: Sex, age, BMI, race, and ethnicity were found to be independent predictors of treatment modality for CTS.
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