Nakamichi K, Tachibana S
Department of Orthopaedic Surgery, Torano-mon Hospital, Tokyo, Japan.
J Hand Surg Br. 1993 Dec;18(6):748-9. doi: 10.1016/0266-7681(93)90236-9.
To assess the association between unilateral carpal tunnel syndrome and space-occupying lesions, 128 patients have been reviewed. They were divided into bilateral, subclinical (unilateral signs and symptoms, and bilateral slowing in the median nerve conduction) and unilateral carpal tunnel syndrome. Space-occupying lesions were investigated on the basis of physical examination and wrist imaging using plain radiographs and ultrasonograms. Of 20 patients with unilateral carpal tunnel syndrome, space-occupying lesions were found in seven (occult ganglion in five and occult calcified mass in two). In contrast, none of 89 patients with bilateral carpal tunnel syndrome and 19 with subclinical carpal tunnel syndrome had space-occupying lesions. We conclude that careful examination and wrist imaging on suspicion of local pathology, especially a space-occupying lesion, are needed when the condition is unilateral and the aetiology is not clear from the history and on physical examination.
为评估单侧腕管综合征与占位性病变之间的关联，我们回顾了128例患者。他们被分为双侧、亚临床（单侧体征和症状，以及正中神经传导双侧减慢）和单侧腕管综合征组。通过体格检查以及使用X线平片和超声进行腕部成像来调查占位性病变。在20例单侧腕管综合征患者中，发现7例存在占位性病变（5例为隐匿性腱鞘囊肿，2例为隐匿性钙化肿块）。相比之下，89例双侧腕管综合征患者和19例亚临床腕管综合征患者均未发现占位性病变。我们得出结论，当病情为单侧且病史和体格检查无法明确病因时，若怀疑存在局部病变，尤其是占位性病变，需要进行仔细检查和腕部成像。
