Carpal tunnel syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

carpal tunnel syndrome is often associated with repetitive work-related motions. Since, there are many conditions cause similar symptoms to CTS, an accurate history and physical examination are essential in this regard.

Differential Diagnosis

• Idiopathic
• Carpometacarpal arthritis of thumb
• Cervical radiculopathy (C6)
• Flexor carpi radialis tenosynovitis
• Median nerve compression at elbow
• Raynaud phenomenon
• Ulnar or cubital tunnel syndrome
• Vibration white finger
• Volar radial ganglion
• Wrist degenerative arthritis
• Rheumatoid Arthritis
• Joint line pain, pain on motion, radiologic finding
• Neck pain, numbness in thumb and index finger only
• Tenderness near base of thumb
• Tenderness at the proximal forearm
• History of symptoms related to cold exposure
• First dorsal interosseous weakness, fourth and fifth digit paresthesias
• Uses vibrating hand tools at work
• Mass near base of thumb, above wrist flexion crease
• Limited motion at wrist, radiologic finding

• Acromegaly
• Amyloidosis
• Benign tumor
• Congestive Heart Failure
• Dermatomyositis
• Diabetes Mellitus
• Estrogens
• Fibrosis of flexor tendons
• Gout
• Hematoma
• Hypothyroidism
• Leprosy
• Mucopolysaccharidoses
• Paget's Disease
• Paraproteinemia
• Pregnancy
• Sarcoidosis
• Scleroderma
• Systemic Lupus Erythematosus
• Tenosynovitis of flexor tendons
• Trauma
• Tuberculosis
• Uremia
• Wrist ganglion