Clinical and Neurophysiological Characteristics of Patients with Carpal Tunnel Syndrome Presenting at the Tertiary Rheumatology Out-Patient Clinic

Abstract

Background: Carpal tunnel syndrome (CTS) is the most commonly-encountered entrapment neuropathy. The classic symptoms of CTS are numbness and paraesthesia in the first three fingers of the hand, which is commonly exacerbated at night. The diagnostic signs include sensory loss along the lateral aspect of the hand, motor weakness and wasting of abductor pollicis brevis muscle. Tinel’s and Phalen’s signs are elicited at the wrist. Methods: This is a prospective analysis of clinical and electrophyisologic study performed on patients that attended the rheumatology outpatient clinic of a tertiary institution. The primary patients of the unit and those that were referred to the rheumatology clinic on account of clinical features of CTS were included in the study. Excluded from the study were pregnant women and those with previous history of CTS surgery. Nerve conduction study was carried out on all patients with features of nerve compression at the wrist. Results: Sixty nine (69) patients out of 82 that presented with clinical features of CTS were diagnosed of CTS. Females constituted 84.1% (58) and males were 15 .9% (11). The most affected age group was (31-40) years. Diabetes patients had the highest presentation of CTS (42%). The classic history of CTS was reported in 33.3%, Paraethesia was observed in 46.4%, numbness in 44.9% while paraethesia and numbness together were reported in 40.6% of patients. Day pain and nocturnal pain was seen in 60.9% and only nocturnal pain was reported by 42.0%. Abductor policis brevis (APB) muscle weakness was found in 24.6% of patients while 11.65% had wasting of the muscle. Conclusion: CTS was fairly common among the rheumatology patients and diabetes patients were predominantly affected.