Nerve Compression Research Articles

Rare entrapment neuropathies of the lower extremity: A narrative review.

Lower limb entrapment neuropathies comprise a wide range of disorders, including less common conditions like tarsal tunnel syndrome, Morton neuroma, obturator nerve entrapment syndrome, superior gluteal nerve entrapment, and cluneal nerve entrapment syndrome. Despite being less prevalent, these syndromes are equally significant, presenting with symptoms such as pain, dysesthesia, muscular weakness, and distinct physical signs. Accurate diagnosis of these less common disorders is crucial for successful therapy and patient recovery, as they can sometimes be mistaken for lumbar plexopathies, radiculopathies, or musculotendinous diseases. This narrative review highlights the significance of identifying and diagnosing these particular neuropathies through a comprehensive assessment of the patient's medical history, detailed physical examination, and the use of electrodiagnostic and/or ultrasound investigations. When the diagnosis is uncertain, advanced imaging techniques like magnetic resonance neurography or magnetic resonance imaging are necessary to confirm the diagnosis. A positive diagnosis ensures prompt and targeted treatments, preventing further nerve impairments and muscle wasting. This article explores the epidemiology, anatomy, pathophysiology, etiology, clinical presentation, and electrodiagnostic interpretation of lower limb entrapment neuropathies, highlighting the importance of precise diagnosis in achieving favorable patient outcomes.

A rare case of proximal arm neurofibroma causing ulnar nerve compression: successful surgical intervention and recovery

A rare case of proximal arm neurofibroma causing ulnar nerve compression: successful surgical intervention and recovery

A positive scratch collapse test in anterior cutaneous nerve entrapment syndrome indicates its neuropathic character.

Chronic abdominal pain is occasionally caused by an abdominal wall entity such as anterior cutaneous nerve entrapment syndrome (ACNES). This syndrome is thought to occur due to intercostal nerve branches (T7-12) that are entrapped in the rectus abdominis muscles. The diagnosis is largely based on subjective clues in patient history and physical examination. A test referred to as the scratch collapse test (SCT) is used as an additional diagnostic tool in peripheral nerve entrapment syndromes such as the carpal tunnel syndrome. The aim of the present study is to investigate whether an SCT was positive in patients with suspected ACNES. If so, this finding may support its hypothesized neuropathic character. A prospective, case-control study was performed among patients with ACNES (n = 20) and two control groups without ACNES (acute intra-abdominal pathology n = 20; healthy n = 20), all were consecutively included. ACNES was diagnosed based on previously published criteria. The SCT test was executed at the painful abdominal area in both patient groups and at a corresponding area in healthy controls. Predictive values, sensitivity, and specificity were calculated. Videos of tests were evaluated by blinded observers. SCT was judged positive in 19 of 20 ACNES patients but not in any of the 40 controls. A 95% sensitivity (confidence interval [CI]: 75-99) and optimal specificity (100%; CI: 83-100) were calculated. The positive SCT supports the hypothesis that ACNES is an entrapment neuropathy. A positive SCT should be considered a major diagnostic criterion for ACNES.

Sciatica secondary to deep venous thrombosis of the persistent sciatic vein: the first case in the literature. Illustrative case.

Sciatica usually results from lumbar nerve compression due to factors like disc herniations or lumbar canal stenosis. Despite its common causes, sciatic pain in a 52-year-old man following a coronavirus disease 2019 infection highlighted the importance of considering less common factors. Initially, minor disc protrusions were suspected as the cause of the symptoms, leading to the offer of surgery at another facility. The patient sought a second opinion, and our evaluation revealed a unique finding. Pelvic magnetic resonance imaging uncovered varicose structures displacing the left sciatic nerve. Subsequent pelvic computed tomography angiography identified a remarkable finding-the lack of opacification in a left persistent sciatic vein ascending toward a left internal iliac vein, originating from a common internal iliac venous trunk-confirming a suspicion for deep venous thrombosis. These findings represented not 1, but 2, extremely rare and distinct variants in the venous anatomy. The authors promptly initiated anticoagulant therapy and tailored pain management strategies, observing progressive thrombosis resolution on follow-up imaging. This report highlights the need for comprehensive diagnostics when symptoms and imaging differ. Misdiagnosis could lead to unnecessary surgeries and potential risks for the patient. https://thejns.org/doi/10.3171/CASE23652.

Ultrasound-Guided Releases of Common Upper Extremity Nerve and Tendon Entrapments

Ultrasound-Guided Releases of Common Upper Extremity Nerve and Tendon Entrapments

Nerve injury associated with shoulder surgery

Introduction Progress in shoulder surgery is associated with improved operating rooms equipment, advanced surgical products and minimally invasive techniques. There are rare injuries to nerves and vessels being intersected or pulled into the sutures. However, marginal tears, compression and nerve entrapment of trunks during access retraction, catheterization, inadequate correct of the patient on the operating table and errors in rehabilitation can be common.The purpose was to identify factors predisposing to peripheral nerve injury to the upper limb during shoulder surgery and offer prevention options.Material and methods Major studies in the field of shoulder anatomy and surgery published between 1984 and 2023 were reviewed to identify anatomical, biomechanical and perioperative factors leading to peripheral nerve injuries. The original literature search was conducted on key resources including GoogleScholar, PubMed, ScienceDirect, RSCI, Scopus. Four approaches were used for structuring and informative presentation of the data to include types of the peripheral nerve injury in the upper limb.Results and discussion Factors predisposing to the peripheral nerve injury in the upper limb during shoulder surgery were identified in the review. Prevention measures include the patient positioned on the operating table with adequate fixation of the head and torso, regardless of the chosen position; traction of the involved upper limb with a load of not greater than 9 kg using a specialized clamp; preoperative marks of the surgical field and staining of bone landmarks; the arthroscopic ports 1–2 cm to be shifted more distally minimizing the fluid flow into the joint during a long operation. Postoperative consultation with rehabilitation specialists is essential to develop an early activation program and assess the risks of neurological disorders.Conclusion The shoulder anatomy and the localization of unsafe zones of the shoulder, the risks associated with a particular manipulation were explored for effective preoperative planning and prevention of neurological complications in the treatment of surgical pathology of the shoulder joint.

A Complex Presentation of Vestibular Paroxysmia in an Adolescent With Wolff- Parkinson-White Syndrome

Vestibular paroxysmia is an episodic vestibular disorder resulting from compression or irritation of the eighth cranial nerve. This disorder is a rare and difficult diagnosis in children. We report the case of a 16-year-old adolescent male with a history of syncope and coronavirus disease 2019 infection four months prior who presented with intermittent episodes of vertigo and unsteadiness several times a week. These events started abruptly, and he appeared frozen. However, he remained conscious and was able to answer questions. He subsequently resumed normal activity in less than a minute without seizure stigmata or postictal period. His general and neurological examinations were unremarkable. Extensive diagnostic evaluation yielded negative results, except for an electrocardiogram consistent with Wolff-Parkinson-White syndrome. However, his symptoms persisted after cardiac ablation, suggesting they were not related to this arrhythmia. Following unsuccessful trials with various medications, his symptoms resolved with carbamazepine. Early recognition and appropriate treatment of this condition could substantially improve the quality of life for affected individuals.

Advancing the Diagnosis of Diabetic Neuropathies: Electrodiagnostic and Skin Autofluorescence Methods.

Diabetic neuropathy (DN) is a generic term for various neuropathies coexisting in a single patient. Clinical diagnosis alone can be misleading, yet routine electrodiagnostic studies in diabetes care are rare. Skin autofluorescence (SAF) is a recognized DN risk factor with potential screening value. This article highlights the diagnostic challenges and raises awareness of the often underdiagnosed neuropathic conditions in diabetes patients. We present common entrapment neuropathy cases from our diabetes clinic's electrodiagnosis laboratory in Iași, Romania. We selected seven type 2 diabetes patients with sensory or sensory-motor distal polyneuropathy and atypical DN presentations investigated through electroneurography (ENG) and electromyography (EMG) with the Neurosoft® EMG instrument and SAF measured by standard procedures. Subsequently, a narrative literature review was conducted. Entrapment neuropathies were diagnosed in all the patients: three carpal tunnel syndromes, two ulnar neuropathies (one proximal, one distal), one peroneal neuropathy, and one case of meralgia paresthetica. The lower-limb cases showed radiculoplexopathy, and there was one case of superficial radial nerve neuropathy. The SAF values ranged from 2.5 AU to 3.4 AU. Electrodiagnosis is essential for detecting focal neuropathies in patients with sensory-motor distal polyneuropathy. Elevated SAF levels may correlate with symptom severity, although further research, including large cohorts, is needed.

Effectivenes of Gliding Exercise Therapy In Carpal Tunnel Syndrome (CTS) Patients : Literature Review

Carpal Tunnel Syndrome (CTS) is a condition characterized by pain, numbness, and tingling in the hand, particularly in the thumb, index finger, middle finger, and part of the ring finger. This condition occurs due to compression of the median nerve passing through the carpal tunnel in the wrist. This study aims to evaluate the effectiveness of gliding exercises in improving CTS symptoms and the functional status of patients. The method used is a literature review, with inclusion criteria for research articles from 2013 to 2023. The results from the five selected studies indicate that gliding exercises can significantly reduce pressure on the median nerve, thereby alleviating symptoms and enhancing the functional capacity of the hand in CTS patients. These exercises were performed once a week for 30 minutes over a period of 3 to 8 weeks, depending on the patient's condition. Gliding exercises have been proven effective as a non-medical intervention in the management of CTS, though some controversy regarding the potential risk of shifting the involved anatomical structures should be considered.

Unusual cause of incomplete cauda equina syndrome: dermoid cyst with a split cord malformation case report

Cauda equina syndrome is a surgical emergency caused by the compression of the lumbosacral nerves. The most frequent cause is discal herniation, while tumoral pathology in this region is rare, and congenital processes are less common. We report the case of a young 37-year-old male patient, admitted to the emergency room with an incomplete cauda equina syndrome. As medical history, a lumbar surgery 15 years ago was reported with no documentation. An MRI was performed, revealing a mass within the filum terminal exhibiting three components suggestive of a dermoid cyst accompanying a split cord malformation, which was confirmed by pathology. Various disorders may be associated to intradural dermoid cyst, such as lipoma, low-lying cord, hydromyelia or thick filum. Surgery is the treatment of choice, and MRI plays a crucial role in detecting associated abnormalities and determining surgery priorities.

Bioinformatics Analysis of Differentially Expressed Genes in Carpal Tunnel Syndrome Using RNA Sequencing.

Carpal tunnel syndrome (CTS) is a common disease resulting from the median nerve entrapment at the wrist. Although CTS (prevalence=5%-10% in the general population) is the most common neuropathy, its molecular mechanisms need elucidation. We used bioinformatics to detect genes with differential expressions in CTS and introduce the molecular regulatory noncoding RNAs and signaling pathways involved. The raw files of the RNA sequencing of CTS patients and controls were obtained from GEO (accession: GSE108023), and the samples were analyzed. Differentially expressed genes were isolated using DESeq2 R. Functional analyses were conducted on the signaling pathways, biological processes, molecular functions, and cellular components of the differentially expressed genes. Additionally, interactions between the most differentially expressed genes and miRNAs and lncRNAs were investigated bioinformatically. Upregulation and downregulation were observed in 790 and 922 genes, respectively. The signaling pathway analysis identified the metabolism pathways of arachidonic acid, linoleic acid, and tyrosine as the most significant pathways in CTS. Moreover, PLA2G2D and PLA2G2A with upregulated expressions and PLA2G2F, PLA2G4F, PLA2G4D, PLA2G3, and PLA2G4E with downregulated expressions were genes from the phospholipase family playing significant roles in the pathways. Further analyses demonstrated that hsa-miR-3150b-3p targeted PLA2G2A and PLA2G4F, and RP11-573D15.8-018 lncRNA had regulatory interactions with the aforementioned genes. Molecular studies on CTS will clarify the involved signaling pathways and provide critical data for biomedical research, drug development, and clinical applications.

Visual morbidity in macroprolactinoma: A retrospective cohort study.

The management of visual field damage in patients with macroprolactinomas is a major therapeutic challenge. We aimed to study the visual morbidity associated with macroprolactinoma and its outcomes following medical and surgical treatment. We aimed to identify predictors of visual recovery. We retrospectively reviewed patient's data including clinical presentation, serial pituitary magnetic resonance imaging, laboratory tests, visual symptoms and neuro-ophthalmologic examination, visual field tests and optical coherence tomography tests. The main outcome was complete visual field recovery. Descriptive analyses were conducted. Predictors of visual recovery were investigated. The study cohort included 150 patients with macroprolactinoma [median follow-up, 6.0 years (interquartile range (IQR) 2.9-10.6)]. At diagnosis, visual field defects were evident in 40 patients (26.7%). At the end of follow-up, 24 out of 39 available visual field tests (61.5%) exhibited complete recovery. Patients that achieved complete visual recovery had smaller macroadenomas at diagnosis [30.5 mm (15.0-80.0) vs. 42.0 mm (30.0-85.0), p < .01], lower baseline serum prolactin levels [1414 mcg/L (489-3586) vs. 4119 mcg/L (2715-6315), p < .01], lower rates of central hypogonadism (78.3% vs. 93.3%, p = .05) and central hypothyroidism (20.8% vs. 53.3%, p = .04), lower rates of compressive optic neuropathy (35.3% vs. 87.5%, p = .02) and a better visual acuity (better than 6/8 in both eyes, 93.7% vs. 28.6%, p < .01). In our cohort of 150 patients with macroprolactinoma, 40 patients (26.7%) presented with visual field defects, of which 61.5% achieved complete visual recovery with treatment. Patients that achieved complete visual recovery presented with smaller macroadenomas, lower serum prolactin levels, lower rates of central hypogonadism and central hypothyroidism, lower rates of compressive optic neuropathy and better visual acuity.

Role of blood flow in intracanal pressure: a novel theory of carpal tunnel syndrome etiology

Carpal tunnel syndrome is the most common compressive neuropathy of the upper extremity. It is believed that the cause of carpal tunnel syndrome is an increase in intracanal pressure, which leads to disruption of the blood supply to the median nerve and the occurrence of neurological disorders. The level of interstitial pressure is an indicator that describes the state of the microvasculature of the surrounding tissues. However, the question of the influence of changes in blood flow on the development of carpal tunnel syndrome still remains open. Purpose: to study the role of blood flow in the formation of intracanal pressure and the development of carpal tunnel syndrome. Objectives of the study: 1. To evaluate pressure levels in the carpal tunnel in patients with carpal tunnel syndrome and in healthy volunteers; 2. To study changes in pressure in the carpal tunnel in the absence of blood circulation in the limb in patients with carpal tunnel syndrome and in healthy volunteers; 3. To assess changes in carpal tunnel pressure before and after median nerve decompression in patients with carpal tunnel syndrome. We studied 40 people of both sexes aged from 21 to 82 years (mean age 50.1 years), divided into 2 groups. Group I included 20 patients with an established diagnosis of primary carpal tunnel syndrome. Group II, the control group, included 20 healthy volunteers. All participants had interstitial pressure measured in the carpal tunnel. In group I, the patients with carpal tunnel syndrome, 4 measurements were performed: before the start of surgery before a tourniquet was applied, 5 minutes after the tourniquet was applied (in the absence of blood circulation), then intraoperatively after decompression was performed in the conditions of a tourniquet applied and 5 minutes after its removal and restoration of blood circulation. In group II, 2 measurements were taken: before applying the tourniquet and after removing it. It was revealed that with carpal tunnel syndrome, the pressure inside the tunnel increased from 8 mm Hg normally to 24.5 mm Hg. When decompression is performed in patients with primary compressive neuropathy of the median nerve, a significant decrease in pressure in the carpal tunnel is observed from 24.5 mm Hg to 8 mm Hg. Even a short-term cessation of blood circulation in the upper limb leads to an increase in pressure inside the carpal tunnel.

Case Report: Radiofrequency Pulsed Therapy for Glossopharyngeal Neuralgia with Associated Syncope

Glossopharyngeal neuralgia (GPN) is characterized by paroxysmal, severe, and lancinating pain at the base of the tongue and throat on one side, often radiating to the oropharynx or ear. The intensity of the pain can be debilitating and, in severe cases, may be accompanied by potentially life-threatening conditions such as cardiac arrhythmias and syncope, significantly impacting the patient&amp;apos;s quality of life. The incidence of GPN is low, and there is limited clinical awareness and understanding of the condition, leading to a high rate of misdiagnosis. In recent years, pulsed radiofrequency has emerged as an effective and minimally invasive treatment modality for the management of GPN. We report a case of a 56-year-old male patient with recurrent glossopharyngeal neuralgia accompanied by syncope. The patient tested positive for the topical application of local anesthetics, and cranial nerve magnetic resonance imaging (MRI) revealed compression of the right glossopharyngeal nerve by a small blood vessel. Both 24-hour Holter monitoring and video electroencephalography (EEG) showed no abnormalities. In addition to treatment with carbamazepine and pregabalin, the patient&amp;apos;s pain as well as syncope resolved after two sessions of CT (ComputedTomography)-guided pulsed radiofrequency (PRF) therapy of the glossopharyngeal nerve. Clinicians should be aware of the rare clinical occurrence of glossopharyngeal neuralgia with syncope. PRF is a measure of safe and effective which could be considered the first choice for minimally invasive therapy.

Orbital Involvement as an Initial Presentation of Sinonasal Neuroendocrine Carcinoma

Purpose: To present a case of sinonasal neuroendocrine cancer initially manifesting with orbital involvement.Case summary: A 63-year-old female patient visited a neuro-ophthalmologic clinic due to a 3-week history of decreased visual acuity (VA), color vision abnormalities, and swelling of the upper eyelid in right eye. Best-corrected VA (BCVA) in the right eye was 0.8. Clinical findings included a relative afferent pupillary defect, restricted eye movement in lateral, superior, and medial gaze, and exophthalmos in the right eye. Wide-field fundus photography and optical coherence tomography indicated swelling of right optic disc. Magnetic resonance imaging was performed revealing a mass invading nasal cavity, sinus, and right orbital apex, and compressing the medial rectus, inferior rectus, superior oblique, and optic nerve. An otolaryngological nasal biopsy was conducted and immunohistochemical staining showed positive results for Ki-67, NSE, p16, P-53, and CD56, leading to a diagnosis of small cell neuroendocrine carcinoma with an irreducible tumor stage. Prior to initiation of treatment (concurrent chemoradiotherapy, CCRT), there was rapid worsening of VA and eye movement in the right eye. CCRT commenced alongside high-dose steroid treatment. One month following treatment, the BCVA of the right eye improved and protrusion of the right eye resolved. Six months after starting CCRT, a contrast-enhanced orbital computed tomography scan showed no residual lesion. The BCVA of the right eye stabilized at 0.3 with complete recovery of color vision and eye movement.Conclusions: Neuroendocrine cancer should be considered as a possible diagnosis in cases of rapidly progressing compressive optic neuropathy.

Awareness and management of slipping rib syndrome

Slipping Rib Syndrome (SRS) is a clinical condition caused by the instability of the costochondral junction, primarily affecting the lower ribs (8th, 9th, and 10th). This syndrome results in severe, often intermittent chest pain due to intercostal nerve entrapment. Diagnosing SRS can be challenging as symptoms often mimic other causes of chest pain. Key clinical features include sharp lower rib pain exacerbated by movement, tenderness on palpation, and pain provoked by the Hooking maneuver. Recent advances in diagnosis and treatment have been highlighted in the literature. Ultrasound has proven effective in confirming SRS diagnosis non-invasively, while surgical interventions offer excellent pain relief, with new diagnostic signs such as reduced rectus abdominis muscle thickness being proposed. Treatment ranges from intercostal nerve blocks and botulinum toxin injections for symptomatic relief to surgical excision of affected costal cartilage for more severe cases. Minimally invasive rib fixation and costal cartilage excision have shown success, providing less invasive options with faster recovery. Continued research and awareness are essential for improving SRS diagnosis and treatment, significantly enhancing patient quality of life.

The accessory brachioradialis muscle: prevalence of a rare variant with possible clinical implications.

The brachioradialis muscle (BRM) belongs to the lateral group of forearm muscles and contributes to the elbow flexion. Accessory brachioradialis muscle (ABRM) or "brachioradialis accessorius" represents an uncommon BRM variant, not been enough studied. The present study investigates the prevalence of the ABRM, along with its origin, insertion, and innervation. Eighty-three upper limbs were meticulously dissected at the arm, forearm, and cubital fossa to investigate the ABRM presence. When the variant muscle was identified, morphometric measurements were obtained. The ABRM was identified in two upper limbs (2/83, 2.4%), in a male cadaver, bilaterally. Its origin was located along with the typical BRM, and its insertion was identified into the anterior surface of the radius (proximal third). The ABRM was innervated by the radial nerve, coursing posteriorly (deeply). In the current study, the variant muscle was observed in 2.4%. Radial nerve compression, at the forearm, is not an uncommon entrapment neuropathy. The relationship between the radial nerve and the ABRM could precipitate radial neuropathy.

A META-ANALYSIS COMPARING THE CLINICAL OUTCOMES OF LUMBAR FUSION AND DYNAMIC STABILIZATION

BackgroundIt has become increasingly important to conduct studies assessing clinical outcomes, reoperation rates, and revision rates to better define the indications and efficacy of lumbar spinal procedures and its association with symptomatic adjacent segment degeneration (sASD). Adjacent segment degeneration (ASD) is defined as the radiographic change in the intervertebral discs adjacent to the surgically treated spinal level. SASD represents adjacent segment degeneration which causes pain or numbness due to post-operative spinal instability or nerve compression at the same level. The most common reason for early reoperation and late operation is sASD, therefore is in our best interest to understand the causes of ASD and make steps to limit the occurrence.MethodA comprehensive literature search was performed selecting Randomized controlled trials (RCTs) and retrospective or prospective studies published up to December 2023. Meta-analysis was performed on 38 studies that met the inclusion criteria and included data of clinical outcomes of patients who had degenerative disc disease, disc herniation, radiculopathy, and spondylolisthesis and underwent lumbar fusion or motion-preservation device surgery; and reported on the prevalence of ASD, sASD, reoperation rate, visual analogue score (VAS), and Oswestry disability index (ODI) improvement.ResultsWhen compared to fusion surgery, a significant reduction of ASD, sASD and reoperation was observed in the cohort of patients that underwent motion-preserving surgery.ConclusionDynamic fusion constructs are treatment options that may help to prevent sASD.Conflicts of interestThis research was funded by Paradigm SpineSources of fundingParadigm Spine

“I CAN'T TAKE IT ANYMORE”: THE EXPERIENCE OF BEING MANAGED FOR SUSPECTED CAUDA EQUINA SYNDROME IN THE EMERGENCY DEPARTMENT

Purpose and backgroundCauda equina syndrome (CES) leads to nerve compression in the lumbar spine, and requires immediate treatment to prevent permanent neurological dysfunction, including urinary/anorectal incontinence. The consequences for the patient are significant as, in the decade to 2018, CES has cost the NHS £186,134,049. No study has reported patients’ experiences of being managed with suspected CES in an emergency department (ED), and this study explores patients’ experiences and how the NHS can optimise care for patients experiencing this condition.Methods and ResultsIn this qualitative secondary analysis, 14 participants (aged 23–63 years) with suspected CES were purposively sampled from 4 EDs in England. Online, semi-structed interviews were undertaken (in 2021, during the pandemic), and were audio-recorded and transcribed verbatim. Data were managed using a Framework approach and analysed thematically.Three themes were identified: quality of care; environmental factors; and expectations. The quality of care included managing uncertainty, the importance of communication, appropriate assessment and follow-up care. Environmental factors, including the chairs, waiting times and the busy nature of the ED, negatively impacted patients’ experiences. Furthermore, an expectation gap was identified, as most individuals came to the ED expecting to receive a scan, an accurate diagnosis and a cure. Despite frustrations, patients expressed gratitude towards the ED staff.ConclusionThis study highlights the importance of empathically acknowledging the patient's pain and providing comprehensive assessments and management plans for people attending ED with suspected CES. Optimising the ED environment to minimise patients’ pain and distress while waiting to access care is paramount and overdue.No conflicts of interest Sources of fundingFunding for primary data: Health Education England &amp; National Institute of Health and Care Research (ICA-CDRF-2018-04-ST2-040)

Carpal tunnel syndrome related to rheumatic disease (Review).

Carpal tunnel syndrome (CTS) is the most commonly occurring type of entrapment neuropathy in the world. Several conditions may contribute to the development of CTS, such as obesity, repetitive wrist movements, pregnancy, genetic predisposition and rheumatoid arthritis (RA) inflammation. CTS is characterized by a wide range of pathophysiological factors, including increased pressure, mechanical trauma and ischemic damage to the median nerve that runs through the wrist tunnel. In the present narrative literature review, the way rheumatic diseases (RDs) contribute to CTS occurrence is investigated. The epidemiological, clinical, paraclinical and pathogenesis aspects of the relationship are examined. CTS is the most common neurological finding in RA, and incidences of RA, psoriatic arthritis and CTS are closely related. The association of CTS with systemic lupus erythematosus, Sjögren's syndrome, Behcet's disease and systemic sclerosis is weaker. In these cases, the prevalence of CTS is similar to that in the general population. As the occurrence of CTS is increasing, understanding the common mechanism and making an early diagnosis are required to limit pain and costs. When patients with RD present with symptoms such as wrist pain, tingling sensations or numbness in their fingers, CTS should be suspected. This suspicion should not be interpreted in terms of RD. To accurately evaluate patients with RD, a detailed electrophysiological examination should be included in the evaluation process. A diagnostic algorithm should include neuromuscular ultrasound or magnetic resonance imaging for patients with RD.