Abstract
A 45-year-old seamstress presents to the clinic with a 4-year history of paresthesias of the volar right thumb, index, and middle finger with associated pain. Patient notes symptoms are worse at night. On examination, patient has decreased sensation on the volar thumb, index, and middle finger as well as the dorsal finger tips and a positive Tinel’s sign and Phalen’s test at the wrist. Strength in her abductor pollicis brevis is normal at 3/5 compared to the contralateral side and she has moderate thenar atrophy, but no hypothenar or intrinsic muscle atrophy. The hand is well perfused and there are no surgical or traumatic scars of the hand or wrist. She has no past medical history and no history of cancer.
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