Carpal Tunnel Syndrome Caused by Space Occupying Lesions

Abstract

Purpose: To evaluate the diagnosis and treatment of the carpal tunnel syndrome (CTS) due to space occupying lesion (SOL)s. Materials and Methods: 14 patients (15 cases) that underwent surgery from 1992 to 2002 for CTS due to SOL were studied. The average age was 51 years. There were 6 men and 8 women. Mean follow up period was 16 months. In patients with swelling or tenderness on the area of wrist flexion creases, MRI and/or CT scan were additionally taken as well as the carpal tunnel view. We performed conventional open transverse carpal ligament release and removal of SOL. Results: The types of lesion were, in three cases tuberculosis tenosynovitis, nonspecific tenosynovitis in three cases, gout in one case, mass in four cases, and abnormal palmaris longus hypertrophy in one case. Bony lesions were, in one case Kienbock’s disease (stage III), neglected volar dislocation of lunate in two cases. Following surgery, all cases showed alleviation of symptoms. Conclusion: In cases with swelling or tenderness on the area of wrist flexion creases, it is important to obtain a carpal tunnel view, and if necessary, MRI and/or CT should be supplemented in order to rule out SOLs.