Carpal tunnel syndrome is the most common peripheral entrapment neuropathy. We
report on the first Korean case of
carpal tunnel syndrome induced by tophaceous deposition in flexor digitorum
tendons of a
patient with chronic
gout. A 63-year-old
male suffered from
numbness, decreased
sensation over both
median nerve distribution, and weakness of thenar
muscle for 3 years.
Physical examinations revealed positive Tinel's sign and Phalen's test and thenar qjmuscle
atrophy was found on both
hands. In
nerve conduction study, there was no
action potential of the sensory and motor of the bilateral
median nerve.
Ultrasonography showed increased cross-sectional area of
median nerve due to tophaceous deposition in flexor digitorum
tendons in the carpal tunnel. Dual-energy computed
tomography showed diffuse multifocal green
color coding tophaceous deposition within the carpal tunnel. His neuropathic symptoms improved after
injection of
triamcinolone into the carpal tunnel and
administration of oral medication including non-steroidal anti-inflammatory
drugs and
colchicine.