Chronic carpal tunnel syndrome caused by covert tophaceous gout: A case report.

Content Provider	Europe PMC
Author	Luo, Peng-Bo Zhang, Chang-Qing
Copyright Year	2018
Abstract	Carpal tunnel syndrome (CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons, tendon sheaths, the carpal tunnel floor, transverse carpal ligament, and even the median nerve, causing various symptoms such as pain, numbness, and weakness. Tophi forming in the carpal canal can compress the median nerve, leading to CTS. Here, we describe a 25-year-old male with a family history of tophaceous gout who presented with typical CTS symptoms. Although he had chronic numbness in his right hand, he failed to present with any obvious palpable masses on his forearm or hand. However, his family history, laboratory, clinical, and magnetic resonance imaging findings were consistent with tophi deposits. CTS symptoms were eased through surgical removal of tophi and decompression of the median nerve. No recurrences of gout and CTS symptoms were reported at a one-year follow-up. This case shows that CTS symptoms could be the initial manifestation of tophaceous gout. In patients with a family history of gout and with CTS symptoms, imaging examinations are critical for early diagnosis and selecting appropriate treatment. Surgical removal of “covert” tophi and decompression of the median nerve is an effective option for eliminating symptoms.
Volume Number	6
PubMed Central reference number	PMC6134276
Issue Number	9
PubMed reference number	30211208
Journal	World Journal of Clinical Cases
e-ISSN	23078960
DOI	10.12998/wjcc.v6.i9.279
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2018-09-01
Access Restriction	Open
Rights License	This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Carpal tunnel syndrome Tophaceous gout Family medical history Surgery Flexor Tendon
Content Type	Text
Resource Type	Article
Subject	Medicine