Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is the most common median nerve compression neuropathy. Its symptoms and clinical presentation are well known. However, symptoms at median nerve distribution can also be caused by a proximal problem. Pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS)...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/14/3988 |
| _version_ | 1797446285043695616 |
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| author | Pekka Löppönen Sina Hulkkonen Jorma Ryhänen |
| author_facet | Pekka Löppönen Sina Hulkkonen Jorma Ryhänen |
| author_sort | Pekka Löppönen |
| collection | DOAJ |
| description | Carpal tunnel syndrome (CTS) is the most common median nerve compression neuropathy. Its symptoms and clinical presentation are well known. However, symptoms at median nerve distribution can also be caused by a proximal problem. Pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS) with their typical characteristics have been thought to explain proximal median nerve problems. Still, the literature on proximal median nerve compressions (PMNCs) is conflicting, making this classic split too simple. This review clarifies that PMNCs should be understood as a spectrum of mild to severe nerve lesions along a branching median nerve, thus causing variable symptoms. Clear objective findings are not always present, and therefore, diagnosis should be based on a more thorough understanding of anatomy and clinical testing. Treatment should be planned according to each patient’s individual situation. To emphasize the complexity of causes and symptoms, PMNC should be named proximal median nerve syndrome. |
| first_indexed | 2024-03-09T13:38:07Z |
| format | Article |
| id | doaj.art-721f88b0414440fbbdf6c690324e1923 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T13:38:07Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-721f88b0414440fbbdf6c690324e19232023-11-30T21:09:57ZengMDPI AGJournal of Clinical Medicine2077-03832022-07-011114398810.3390/jcm11143988Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel SyndromePekka Löppönen0Sina Hulkkonen1Jorma Ryhänen2Department of Orthopedics and Traumatology, Seinäjoki Central Hospital, FI-60220 Seinäjoki, FinlandDepartment of Hand Surgery, Helsinki University Hospital, University of Helsinki, FI-00029 Helsinki, FinlandDepartment of Hand Surgery, Helsinki University Hospital, University of Helsinki, FI-00029 Helsinki, FinlandCarpal tunnel syndrome (CTS) is the most common median nerve compression neuropathy. Its symptoms and clinical presentation are well known. However, symptoms at median nerve distribution can also be caused by a proximal problem. Pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS) with their typical characteristics have been thought to explain proximal median nerve problems. Still, the literature on proximal median nerve compressions (PMNCs) is conflicting, making this classic split too simple. This review clarifies that PMNCs should be understood as a spectrum of mild to severe nerve lesions along a branching median nerve, thus causing variable symptoms. Clear objective findings are not always present, and therefore, diagnosis should be based on a more thorough understanding of anatomy and clinical testing. Treatment should be planned according to each patient’s individual situation. To emphasize the complexity of causes and symptoms, PMNC should be named proximal median nerve syndrome.https://www.mdpi.com/2077-0383/11/14/3988carpal tunnel syndromemedian neuropathymedian nerve entrapmentneuralgic amyotrophypronator syndrome |
| spellingShingle | Pekka Löppönen Sina Hulkkonen Jorma Ryhänen Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome Journal of Clinical Medicine carpal tunnel syndrome median neuropathy median nerve entrapment neuralgic amyotrophy pronator syndrome |
| title | Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome |
| title_full | Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome |
| title_fullStr | Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome |
| title_full_unstemmed | Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome |
| title_short | Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome |
| title_sort | proximal median nerve compression in the differential diagnosis of carpal tunnel syndrome |
| topic | carpal tunnel syndrome median neuropathy median nerve entrapment neuralgic amyotrophy pronator syndrome |
| url | https://www.mdpi.com/2077-0383/11/14/3988 |
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