Neglected lunate dislocation presenting as carpal tunnel syndrome

Area of Science:

• Orthopedics
• Neurology
• Anatomy

Background:

• Carpal tunnel syndrome (CTS) is a common condition, frequently idiopathic.
• Secondary causes of CTS are less common and can be overlooked.
• Median nerve compression at the wrist is the primary pathology in CTS.

Observation:

• A patient presented with clinical signs and symptoms consistent with carpal tunnel syndrome.
• Initial assessments did not readily identify a secondary cause for the carpal tunnel syndrome.
• A neglected, undiagnosed lunate dislocation was identified as the underlying etiology.

Findings:

• The lunate dislocation was exerting direct pressure on the median nerve.
• This mechanical compression mimicked the typical presentation of idiopathic carpal tunnel syndrome.
• Prompt diagnosis of the dislocation led to appropriate management.

Implications:

• This case underscores the importance of considering rare secondary causes in CTS diagnosis.
• Lunate dislocations should be included in the differential diagnosis for persistent or atypical CTS.
• Accurate diagnosis of underlying bone or joint pathology is crucial for effective CTS treatment.