Transverse ultrasound for carpal tunnel syndrome pdf at the wrist. The median nerve is colored yellow. The carpal tunnel consists of the bones and transverse carpal ligament.
The main symptoms are pain, numbness, and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers. Symptoms typically start gradually and during the night. Pain may extend up the arm. Weak grip strength may occur and after a long period of time the muscles at the base of the thumb may waste away.
In more than half of cases both sides are affected. Risk factors include obesity, repetitive wrist work, pregnancy, and rheumatoid arthritis. There is tentative evidence that hypothyroidism increases the risk.
Diabetes mellitus is weakly associated with CTS. The use of birth control pills does not affect the risk.
Types of work that are associated include computer work, work with vibrating tools, and work that requires a strong grip. Diagnosis is suspected based on signs, symptoms, and specific physical tests and may be confirmed with electrodiagnostic tests. If muscle wasting at the base of the thumb is present, the diagnosis is likely.