Related Experiment Video
Updated: Oct 1, 2026
Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Pitfalls in diagnosing carpal tunnel syndrome
M Rhomberg1, E Herczeg, H Piza-Katzer
1Department of Plastic and Reconstructive Surgery, Leopold-Franzens University Innsbruck, Austria. martin.rhomberg@uibk.ac.at
Insights
Differentiating thumb hypoplasia type 1/11 from carpal tunnel syndrome is crucial. Accurate diagnosis requires thorough history, examination, imaging, and nerve conduction studies for effective treatment.
Area of Science:
- Hand surgery
- Orthopedics
- Pediatric orthopedics
Background:
- Thumb hypoplasia type 1/11 and carpal tunnel syndrome share overlapping symptoms, complicating differential diagnosis.
- Misdiagnosis can lead to delayed or incorrect treatment, impacting patient outcomes.
Observation:
- Two pediatric and one adult patient initially diagnosed with carpal tunnel syndrome were re-evaluated.
- Initial diagnoses in pediatric patients were revised after detailed history and examination.
- The adult patient underwent two unsuccessful carpal tunnel surgeries before correct diagnosis.
Findings:
- Accurate diagnosis necessitates a comprehensive approach including detailed patient history and clinical examination.
- Radiographic evaluation (X-rays) of both hands is essential for identifying thumb hypoplasia.
- Electroneurography and sonography aid in differentiating these conditions.
Implications:
- Emphasizes the importance of a meticulous diagnostic process to avoid surgical errors.
- Highlights the need for specialized knowledge in hand anomalies for correct patient management.
- Improved diagnostic accuracy can lead to timely and appropriate interventions, such as opponensplasty.
Abstract:
The aim of this paper is to point out the differential diagnosis be-tween a thumb hypoplasia type 1/11 and a carpal tunnel syndrome. Both syndromes have symptoms in common. Two children and an adult with hypoplastic thumbs were sent to our department with the diagnosis carpal tunnel syndrome. In both children, the diagnosis was changed after an exact history and examination, and in one child an opponensplasty was done. The adult patient had already been operated unsuccessfully for a carpal tunnel syndrome elsewhere and again at our department. The exact diagnosis was only made after the second operation,when an extended questioning was done. This shows how important a careful history taking, an exact clinical examination, X-ray examinations of both hands, knowledge of type 1/11 hypoplasia, and finally electroneurography and sonography are important for a correct diagnosis.
Related Concept Videos
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:16Muscles of the Forearm that Move the Hand and Fingers
Anterior Compartment
The anterior compartment muscles originate from the humerus. They primarily function as flexors and are also known as flexor muscles. They typically insert on the carpals, metacarpals, and phalanges. The superficial layer includes the flexor carpi radialis,...
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:29Cardiovascular System Abnormal Findings I: Inspection and Palpation
Abnormal findings observed during an inspection