Carpal tunnel syndrome

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Pain in wrist with numbness in first 3 digits.

Patient Data

Age: 35 years
Gender: Female
mri

Mild palmar bowing of flexor retinaculum is seen with thickening of median nerve at carpal tunnel inlet (level of pisiform) and flattening at the carpal tunnel outlet (level of hook of hamate).

Tendinosis with interstitial tear of extensor carpi ulnaris tendon is seen starting at the level of ulnar styloid and extending distally for a length of approx. 13 mm.
Mild degeneration of ulnar attachment of triangular fibrocartilage is seen with no obvious tear.

Subtle cortical irregularity with mild marrow edema is seen involving medial aspect of trapezium. Small subchondral erosions / cyst is seen in base of first metacarpal.

Mild fluid is seen at dorsal aspect of scaphoid.

Case Discussion

Typical findings of carpal tunnel syndrome, which explains the patient's symptoms.

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