Histopathology of the flexor tendon sheaths and its relevance in idiopathic carpal tunnel syndrome

Work-Related Musculoskeletal Disorders of the Hand and Wrist: Epidemiology, Pathophysiology, and Sensorimotor Changes

“…Human studies examining tendon and sheath biopsies collected from patients with chronic tendinopathies or CTS (Table 4) find marked tendon and sheath degeneration and fibrosis in combination with inflammatory or proliferative changes. 8,29,47,51,88 In animal models, marked tendon injury is dependent on force, frequency, and duration of repetitive exposure (Table 3). Tendon necrosis and matrix disorganization are found only in studies utilizing intensive repetitive kicking or intensive running combined with tendon compression.…”

Functional impairment in video terminal operators is related to low-grade inflammation

“…Human studies examining tendon and sheath biopsies collected from patients with chronic tendinopathies found that marked tendon and sheath degeneration was accompanied by inflammatory changes (Campligio et al 1999). …”

Neutrophil/Lymphocyte, Platelet/Lymphocyte and Neutrophil/Monocyte Rates in Carpal Tunnel Syndrome

“…16,17 Although carpal tunnel syndrome has previously shown many localized median nerve and tenosynovium biopsies and inflammation, a limited number of studies have been performed to evaluate inflammation in serum. 5,18 It has been reported that NLR, PLR, NMR and LMR values may lead to diagnosis and prognosis in many systemic diseases such as malignancies, chronic inflammatory diseases, acute myocardial infarction, renal artery stenosis, diabetes mellitus. 19,20 In our study NMR, CRP and platelet values were found to be significantly higher in patients with CTS, but there was no difference in NLR, PLR, and LMR values.…”

“…4 Significant tendon and sheath degeneration and fibrosis in biopsies made in patients with CTS coexist with inflammatory and proliferative changes. 5 Tissue injury cytokines elicit an acute inflammatory response leading to the release of neutrophils and subsequent collagen and fibronectin fragments that attract macrophages. 6 Previously localized tendon and sheath biopsy studies as well as proinflammatory cytokines such as IL-1alpha, IL-6, and TNF-alpha in serum were also performed to evaluate inflammation in CTS .…”