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December 1964

Carpal Tunnel Syndrome as Manifestation of Sarcoidosis

Arch Intern Med. 1964;114(6):830-833. doi:10.1001/archinte.1964.03860120142018

The median nerve is vulnerable to compression as it passes through the rigid carpal tunnel, posterior to the transverse carpal ligament, and anterior to the flexor tendons. Hematomata, edema, urate deposits, granulomata, or fractures within this carpal tunnel have been incriminated as a cause of compression. Paresthesias in the distribution of the median nerve to the hand with ultimate atrophy of the involved muscles may occur. Previous reports have related such an entity to a variety of otherwise unrelated systemic diseases. Rheumatoid arthritis, diabetes mellitus, thyroid adenomas, myxedema, gout, multiple myeloma, acromegaly, and lymphomatous diseases have been etiologically related to a coexistent carpal tunnel syndrome.1,2,5 Sarcoidosis, however, has not been mentioned previously. Two patients with probable sarcoidosis who had an associated bilateral median nerve compression will be described.

Report of Cases 

Case 1.  —A 45-year-old Caucasian male was admitted to Walter Reed General Hospital in February, 1961, with a