| Popis: |
This chapter presents the case of a 42-year-old woman with rheumatoid arthritis (RA) who describes tingling, pins and needles and sometimes burning pain at the right wrist and palmar area of the thumb and index, extending to the forearm. Clinical examination shows no sensorimotor deficit, and percussion of the median nerve at the wrist induces paresthesia. Carpal tunnel syndrome is frequent in RA and mainly a clinical diagnosis. Complementary explorations are not always mandatory. Nerve conduction studies may provide objective confirmation of decreased sensory and motor conduction of the median nerve at the wrist. Imaging particularly using ultrasound can help when there is strong suspicion of a local cause of compression. Nonsurgical treatment includes rest, splinting, and local corticosteroid injections. In refractory cases or when there is motor involvement, surgical decompression is indicated. |
