Carpal tunnel syndrome in children

Meir, Nathalie Van; Smet, Luc De

doi:10.1097/01202412-200501000-00007

Cited by 72 publications

(70 citation statements)

References 30 publications

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“…The tumor may present as a palpable mass of variable size or as spontaneous localized pain; although numbness and muscle wasting may occur, motor or sensory deficits are rare [23,42]. A few cases of carpal tunnel syndrome attributable to a hemangioma of the median nerve have been described as well [6,37]. In our case, the patient presented with a painless, gradually increasing mass and numbness at the median nerve distribution.…”

Section: Discussionmentioning

confidence: 69%

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A 56-year-old Woman with a Right Arm Mass

Papagelopoulos¹,

Mavrogenis²,

Skarpidi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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A 56-year-old woman was admitted for a 5-year history of a painless right arm mass. The patient denied any recent enlargement. However, over the previous 2 years, the patient complained of gradually increasing numbness at the thumb, index finger, and middle finger of the ipsilateral arm. There was no history of trauma. Medical and family history was unremarkable.Physical examination revealed a soft, oval, deep palpable mass on the medial side of her right arm with a maximum diameter of 4 cm (Fig. 1). Passive and active range of motion of the right elbow and hand were unaffected. Neurologic examination was normal. Routine laboratory analysis including complete blood cell count, serum chemistries, erythrocyte sedimentation rate, and C-reactive protein were within normal limits.We performed plain radiography ( Fig. 2), ultrasonography (Fig. 3), and MRI (Fig. 4).Based on the history, physical examination, laboratory tests, and imaging studies, what is the differential diagnosis? Imaging InterpretationA frontal radiograph of the right upper arm showed a cluster of rounded calcifications in the soft tissues along the medial aspect of the mid humerus. No underlying osseous abnormality was noted (Fig. 2).Ultrasonography of the right arm showed a well-defined oval mass with heterogeneous internal echogenicity. The mass was closely related to the median nerve. Doppler examination revealed a moderate degree of vascularity within the lesion (Fig. 3).MRI showed a fusiform lesion with well-circumscribed borders along the posteromedial aspect of the biceps. The lesion was intermuscular and centered along the expected course of the median nerve. The normal median nerve could not be identified as a distinct structure at this level. The lesion was heterogeneous and slightly hypointense to muscle on T1-weighted images (Fig. 4A-B) and heterogeneously hyperintense on T2-weighted images. On postcontrast T1-weighted images (Fig. 4C-D), the mass enhanced in fairly uniform fashion. Differential Diagnosis Hemangioma SchwannomaEach author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution has approved the reporting of this case and that all investigations were conducted in conformity with ethical principles of research.

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Section: Discussionmentioning

confidence: 69%

“…Current treatment for intraneural hemangioma includes intraneural or intrafascicular microdissection with preservation of the continuity of the nerve [2,3,6,23,37]. Nerve grafting may be required if the tumor cannot be resected free of a motor nerve.…”

Section: Discussionmentioning

confidence: 99%

A 56-year-old Woman with a Right Arm Mass

Papagelopoulos¹,

Mavrogenis²,

Skarpidi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…This is especially important in children, who may not complain of symptoms but have electrodiagnostic evidence of nerve damage [1,4,8,9,33]. Patient #3's initially unilateral presentation, but ultimate need for contralateral CTR, illustrates how FCTS can progress to involve both upper extremities, increasing the risk for permanent nerve damage if not appropriately addressed.…”

Section: Discussionmentioning

confidence: 99%

“…Phalen's test was positive at the most small FCTS case series have been published. However, essentially all of these studies lack outcome measures beyond five years postoperatively [2,4,[8][9][10][11][12]. In addition, there are few reports noting outcomes in children afflicted with this condition.…”

Section: Journal Of Aesthetic and Reconstructive Surgery Issn 2472-1905mentioning

confidence: 99%

Primary Familial Carpal Tunnel Syndrome with Long-term Followup: A Study of Two Families and Review of the Literature

Cantwell¹,

Batdorf²

2016

J Aesthet Reconstr Surg

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“…While CTS is associated with a number of systemic diseases and some mechanical and occupational factors (Mattioli et al 2009;Uchiyama et al 2010), a genetic predisposition for CTS has also been shown (Hakim et al 2002;Lozano-Calderon et al 2008). CTS presenting in childhood should prompt consideration of an underlying lysosomal storage disorder or other genetic condition (Van Meir and De Smet 2003;Sri-Ram et al 2007;Yuen et al 2007). Patients presenting to Australian general practice with symptoms of CTS are predominantly female (male-female ratio 2 : 3) and 46% are aged 45-65 years (Charles et al 2009).…”

Section: Discussionmentioning

confidence: 99%

Carpal Tunnel Syndrome in Fabry Disease

et al. 2011

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Carpal tunnel syndrome (CTS) is a common peripheral mononeuropathy affecting up to 4% of the general population, typically women in late middle age. The incidence in patients with Fabry disease (FD) is unclear, but may affect 25% of patients with this X-linked lysosomal storage disease. We report three cases of CTS in young Caucasian male patients with classical FD, who developed CTS symptoms with supportive nerve conduction study (NCS) findings. Two patients had bilateral CTS and two had evidence of concurrent ulnar nerve neuropathy on NCS, suggesting a systemic process contributed to nerve compression. All were receiving enzyme replacement therapy (ERT) and had a moderate burden of FD complications. It is possible that an increase in connective tissue in the intracarpal canal in FD patients may be incited by injury to fibroblasts, via either accumulation of globotriaosylceramide (GL3) or local ischaemia through endothelial injury. The former hypothesis may be a more plausible explanation for the development of CTS, as histology of the flexor retinaculae from our patients has demonstrated fibroblasts with characteristic vacuolation and excessive myxomatous stroma, despite endothelial clearance of GL3 in these patients receiving ERT. CTS should not be overlooked in FD patients and young patients presenting with CTS should be evaluated for an underlying systemic or genetic disorder. Surgical carpal tunnel decompression was effective in our patients, already troubled by long-standing acroparesthesia, in providing sustained relief of symptoms.

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Carpal tunnel syndrome in children

Cited by 72 publications

References 30 publications

A 56-year-old Woman with a Right Arm Mass

A 56-year-old Woman with a Right Arm Mass

Primary Familial Carpal Tunnel Syndrome with Long-term Followup: A Study of Two Families and Review of the Literature

Carpal Tunnel Syndrome in Fabry Disease

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