Carpal tunnel associations

Amyloidosis (primary or secondary)
Acromegaly, 35 %
Rheumatoid arthritis, 23 % (differentiate from disuse, c spine disease, or ulnar n at elbow)
eosinophilic fasciitis
myxedema
lupus erythematosus
hyperparathyroidism
toxic shock syndrome
Colles fracture
Fracture of the capitatum or hamate
soft tissue swelling around wrist after injury
intraneural hemorrhage
anomaly of distal radius
subluxed carpus on distal radioulnar
rubella immunization
DM
Gout
myeloma (=Leri's pleonosteosis)
cerebral palsy
TB
pregnancy
toxic shock s
toxic oil syndrome
mucopolysaccharidosis
congenital av fistula
dialysis
brachial hypertrophy
SLE
scleroderma

Signs/symptoms of CTS
Paresthesias and pain relieved with movement, worse at night
Raynaud's phenomenon
hypesthesias 1st 3 digits and half of fourth
Sensory loss confined to tip of third digit
Sensory splitting of fourth digit on exam
Sparing of thenar eminence
Phalen's and Tinel's signs
Flick sign (relief with shaking wrist) most reliable sign

Motor APB-- pushing up perpendicular to palm
Opponens pollicis -- touch thumb and fifth finger
Phalen's/ Tinel's signs

Differential diagnosis
high median compression at elbow
C 6 radiculopathy
handcuff neuropathy