Abstract
Hypothyroidism is commonly included as an important risk factor for carpal tunnel
syndrome (CTS), yet no study clearly defines the nature of this association. The purpose
of this study was to evaluate the relationship between hypothyroidism and CTS in a
controlled study. Twenty-six hypothyroid patients (45 hands) meeting our inclusion
criteria with a diagnosis of primary hypothyroidism were questioned regarding date
of diagnosis of hypothyroidism, duration and dose of thyroid replacement, and the
presence, character, and duration of CTS symptoms. Twenty-four healthy volunteers
(47 hands) were used as controls. Clinical examination included sensibility testing
with Semmes-Weinstein monofilaments, Weber 2-point discrimination testing, examining
for thenar muscle atrophy and weakness, Phalen's test, Tinel's sign at the wrist,
and the manual compression test. Electrodiagnostic testing including distal motor
latency and distal sensory latency was performed on the median nerve at the wrist
on all subjects. Nineteen patients (73%; 31 hands [68%]) displayed symptoms of CTS;
of these, 16 patients (25 hands) had clinical examinations consistent with CTS. Only
6 of the 16 patients with clinical CTS (7 of 25 hands) had electrical studies that
supported a diagnosis of CTS. All these symptomatic patients were biochemically euthyroid.
All control subjects had normal electrical study results and normal sensibility testing.
Two subjects had positive clinical examinations, giving a false-positive rate of 4%.
Carpal tunnel syndrome symptoms are common in hypothyroid patients even when they
are euthyroid. In this group of patients, normal median nerve latencies at the wrist
in the presence of CTS symptoms and a positive physical examination are more prevalent
than expected by the reported sensitivities of electrodiagnostic testing. Standards
for assessing normal median nerve latencies may be significantly different in hypothyroid
patients. (J Hand Surg 2000;25A:734–739. Copyright © 2000 by the American Society
for Surgery of the Hand.)
Keywords
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Article info
Publication history
Accepted:
March 7,
2000
Received:
January 5,
2000
Footnotes
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**Reprint requests: Robert M. Szabo, MD, University of California, Davis, School of Medicine, 4860 Y St, Sacramento, CA 95817.
*J Hand Surg 2000;25A:734–739.
**0363-5023/00/25A04-0019$3.00/0
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
