Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis

We present a case of carpal tunnel syndrome involving wrist trigger caused by a hypertrophied lumbrical muscle with flexor synovitis. The case was a 40-year-old male heavy manual worker complaining of numbness and pain in the median nerve area. On active flexion of the fingers, snapping was observed...

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Main Authors: Ayuko Shimizu, Masayoshi Ikeda, Yuka Kobayashi, Ikuo Saito, Joji Mochida
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2015/705237
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author Ayuko Shimizu
Masayoshi Ikeda
Yuka Kobayashi
Ikuo Saito
Joji Mochida
author_facet Ayuko Shimizu
Masayoshi Ikeda
Yuka Kobayashi
Ikuo Saito
Joji Mochida
author_sort Ayuko Shimizu
collection DOAJ
description We present a case of carpal tunnel syndrome involving wrist trigger caused by a hypertrophied lumbrical muscle with flexor synovitis. The case was a 40-year-old male heavy manual worker complaining of numbness and pain in the median nerve area. On active flexion of the fingers, snapping was observed at the carpal area, and forceful full grip was impossible. Tinel’s sign was positive and an electromyographic study revealed conduction disturbance of the median nerve at the carpal tunnel. Magnetic resonance imaging revealed edematous lumbrical muscle with synovial proliferation around the flexor tendons. Open carpal tunnel release was performed under local anesthesia. Synovial proliferation of the flexor tendons was found and when flexing the index and middle fingers, the lumbrical muscle was drawn into the carpal tunnel with a triggering phenomenon. After releasing the carpal tunnel, the triggering phenomenon and painful numbness improved.
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series Case Reports in Orthopedics
spelling doaj-art-e3ce0b2da0a24b07bcc7a79a0743b0412025-02-03T01:22:55ZengWileyCase Reports in Orthopedics2090-67492090-67572015-01-01201510.1155/2015/705237705237Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and TenosynovitisAyuko Shimizu0Masayoshi Ikeda1Yuka Kobayashi2Ikuo Saito3Joji Mochida4Department of Orthopaedics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-0198, JapanDepartment of Orthopaedics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-0198, JapanDepartment of Orthopaedics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-0198, JapanDepartment of Orthopaedics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-0198, JapanDepartment of Orthopaedics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-0198, JapanWe present a case of carpal tunnel syndrome involving wrist trigger caused by a hypertrophied lumbrical muscle with flexor synovitis. The case was a 40-year-old male heavy manual worker complaining of numbness and pain in the median nerve area. On active flexion of the fingers, snapping was observed at the carpal area, and forceful full grip was impossible. Tinel’s sign was positive and an electromyographic study revealed conduction disturbance of the median nerve at the carpal tunnel. Magnetic resonance imaging revealed edematous lumbrical muscle with synovial proliferation around the flexor tendons. Open carpal tunnel release was performed under local anesthesia. Synovial proliferation of the flexor tendons was found and when flexing the index and middle fingers, the lumbrical muscle was drawn into the carpal tunnel with a triggering phenomenon. After releasing the carpal tunnel, the triggering phenomenon and painful numbness improved.http://dx.doi.org/10.1155/2015/705237
spellingShingle Ayuko Shimizu
Masayoshi Ikeda
Yuka Kobayashi
Ikuo Saito
Joji Mochida
Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis
Case Reports in Orthopedics
title Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis
title_full Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis
title_fullStr Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis
title_full_unstemmed Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis
title_short Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis
title_sort carpal tunnel syndrome with wrist trigger caused by hypertrophied lumbrical muscle and tenosynovitis
url http://dx.doi.org/10.1155/2015/705237
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