Synovial histology in carpal tunnel syndrome

This study investigates the relationship between idiopathic carpal tunnel syndrome and tenosynovial histology, specifically inflammation. Tenosynovial biopsy specimens from 177 wrists were obtained from patients at carpal tunnel release, and a control group of 19 specimens was also obtained. Inflammation was present in only 10% of the patient specimens and was correlated with only one of the clinical and histologic factors studied, i.e., nerve conduction impairment. Edema, observed frequently (85%), was not correlated with inflammation. Vascular sclerosis was also found consistently (98%) and was correlated with patient age and degree of edema. Edema and vascular sclerosis occurred with significantly greater frequency and severity in the specimens of patients than in the control group. Fibrosis (3%) and synovial hyperplasia (1%) were uncommon findings. It is concluded that tenosynovitis is uncommon in patients undergoing surgery for treatment of idiopathic carpal tunnel syndrome.