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Carpal tunnel syndrome in children
Nathalie Van Meir1, Luc De Smet
1University Hospital Pellenberg, Leuven, Belgium.
Acta Orthopaedica Belgica
|December 3, 2003
Summary
Carpal tunnel syndrome (CTS) in children is rare, often linked to genetic disorders like mucopolysaccharidoses. Early screening is vital for affected children, as symptoms can be masked by other conditions.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Genetics
Background:
- Carpal tunnel syndrome (CTS) is uncommon in pediatric populations.
- A review of 163 cases published since 1989 highlights genetic conditions as the primary etiology.
Observation:
- Lysosomal storage diseases, specifically mucopolysaccharidoses (MPS) and mucolipidoses (ML), are the most frequent causes of pediatric CTS.
- Symptoms in MPS often manifest as fine motor difficulties rather than classic adult CTS signs.
- Other genetic conditions associated with pediatric CTS include primary familial CTS, hereditary neuropathy with liability to pressure palsies (HNPP), and Schwartz-Jampel syndrome (SJS).
Findings:
- Non-genetic causes include idiopathic CTS, intensive sports, macrodactyly, nerve tumors (fibrolipomas, perineuromas, hemangiomas), trauma (distal radius epiphysiolysis), and congenital anomalies.
- Surgical release was performed in 145 of the reviewed cases.
- Pediatric CTS presentation can be atypical, with subtle symptoms and challenges in patient communication.
Implications:
- Early clinical and electrophysiological screening is recommended for children with storage diseases to detect CTS before overt symptoms appear.
- Thorough examination and family history are crucial for diagnosing pediatric CTS.
- Understanding the diverse etiologies is key for appropriate management and intervention in childhood CTS.