ABSTRACT
BACKGROUND: It has been suggested that many patients with carpal tunnel syndrome have associated thyroid or other metabolic diseases. METHODS: 206 patients with clinical features suggestive of carpal tunnel syndrome (CTS), including those with known underlying cause of CTS, were screened for thyroid dysfunction. Nerve conduction studies were compatible with a diagnosis of CTS in 136 patients (CTS group). RESULTS: We diagnosed only 2 new cases of hypothyroidism (1.5% of patients in the CTS group) and none with hyperthyroidism. CONCLUSIONS: Thus routine screening of patients with isolated CTS for thyroid function abnormality does not appear to be worthwhile.
ABSTRACT
The authors have studied 148 consecutive patients with 170 electrophysiologically confirmed ulnar nerve lesions, who were followed up for one to six years (median 3.8 years) to determine clinical progress and outcome. Injury and intra-operative pressure accounted for 12.9% and 7.1% of lesions respectively; 58.2% were idiopathic with no identified clinical aetiological factor. Eighty-three percent received non-operative treatment initially; 21% of these required operative intervention following further clinical/electrophysiological assessment. Partial or complete recovery occurred in 92% of intra-operative, 64% of idiopathic and 50% of injury cases respectively. Ulnar nerve lesions predominate in males and can be treated non-operatively providing clinical and electrophysiological monitoring is possible. Bilaterality is common and should be excluded. Lesions due to injury have a worse prognosis than those caused by direct continuous or repeated pressure, inflammation or where no aetiological factor exists.