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April 30, 1973

Section 32.—Carpal Tunnel Syndrome

JAMA. 1973;224(Suppl_5):751. doi:10.1001/jama.1973.03220190091035

The carpal tunnel syndrome represents one of the so-called entrapment neuropathies and is a common cause of acroparesthesias in the hands. It occurs predominantly in women of middle age, most often in the postmenopausal period.1,2 At the wrist, the median nerve and flexor tendons pass through a common tunnel whose rigid walls are bounded dorsally and on the sides by the carpal bones, and which is enclosed on the volar aspect by the transverse carpal ligament (Fig 63). Any process which encroaches on this crowded tunnel results in compression of the most vulnerable structure, the median nerve.

A variety of disorders may give rise to the syndrome. These include edema following trauma or associated with the fluid retention of pregnancy, overgrowths (osteophytes) of bone, ganglia related to tenosynovial sheaths, lipomata, and infections such as tuberculosis. Various systemic diseases may be associated with the syndrome. Perhaps the commonest is involvement