Carpal tunnel syndrome

Suspect this common syndrome in young women who are pregnant or on oral contraceptives, in menopausal women, in patients performing unaccustomed repetitive manual activity, in those on hemodialysis and in those with endocrine abnormalities. Diagnosis requires precise neurologic examination and electrodiagnostic studies. Conservative therapy includes nonsteroidal anti-inflammatory agents, night-splint immobilization and local steroid injections. Surgical intervention is required for longstanding cases when conservative treatment fails and when muscular atrophy of median innervated thenar muscles develops.