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Previous Volume 346:1807-1812 June 6, 2002 Number 23 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 64-year-old, right-handed, retired woman presents with intermittent numbness, tingling, and burning pain in the three radial digits of both hands. She has had these symptoms for three months, and they awaken her several times each night. She has no atrophy of the thenar muscles. Sensation to light touch is intact. How should she be evaluated and treated?

The Clinical Problem

Hand, finger, or wrist . . . [Full Text of this Article]

Strategies and Evidence

Diagnosis

            History

            Physical Examination

Treatment

            Treating Associated Conditions

            Splinting

            Medications

            Local Corticosteroid Injection

            Surgery

            Alternative Therapies

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Robert B. Brigham Arthritis Research Center, Division of Rheumatology, Immunology, and Allergy (J.N.K.), and the Department of Orthopedic Surgery (B.P.S.), Brigham and Women's Hospital, Harvard Medical School; and the Department of Environmental Health, Harvard School of Public Health (J.N.K.) — both in Boston.

Address reprint requests to Dr. Katz at the Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, or at jnkatz@partners.org.

References

This article has been cited by other articles:

• Smith, J., Wisniewski, S. J., Finnoff, J. T., Payne, J. M. (2008). Sonographically Guided Carpal Tunnel Injections: The Ulnar Approach. J Ultrasound Med 27: 1485-1490 [Abstract] [Full Text]  
• de Rijk, M. C, Vermeij, F. H, Suntjens, M., van Doorn, P. A (2007). Does a carpal tunnel syndrome predict an underlying disease?. J. Neurol. Neurosurg. Psychiatry 78: 635-637 [Abstract] [Full Text]  
• Megerian, J. T., Kong, X., Gozani, S. N. (2007). Utility of Nerve Conduction Studies for Carpal Tunnel Syndrome by Family Medicine, Primary Care, and Internal Medicine Physicians. J Am Board Fam Med 20: 60-64 [Abstract] [Full Text]  
• Mallouhi, A., Pultzl, P., Trieb, T., Piza, H., Bodner, G. (2006). Predictors of Carpal Tunnel Syndrome: Accuracy of Gray-Scale and Color Doppler Sonography.. Am. J. Roentgenol. 186: 1240-1245 [Abstract] [Full Text]  
• Sofat, N., Malik, O., Higgens, C.S. (2006). Neurological involvement in patients with rheumatic disease. QJM 99: 69-79 [Abstract] [Full Text]  
• Gimeno, D, Amick, B C III, Habeck, R V, Ossmann, J, Katz, J N (2005). The role of job strain on return to work after carpal tunnel surgery. Occup. Environ. Med. 62: 778-785 [Abstract] [Full Text]  
• Hui, A.C.F., Wong, S., Leung, C. H., Tong, P., Mok, V., Poon, D., Li-Tsang, C. W., Wong, L. K., Boet, R. (2005). A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome. Neurology 64: 2074-2078 [Abstract] [Full Text]  
• Ruppen, W., Schupfer, G. K. (2005). Exacerbation of Carpal Tunnel Syndrome Under Treatment with Valdecoxib. Anesth. Analg. 100: 1215-1216 [Full Text]  
• LUNDBORG, G., ROSEN, B. (2004). The Two-Point Discrimination Test - Time For a Re-Appraisal?. J Hand Surg Eur Vol 29: 418-422 [Abstract] [Full Text]  
• Hughes, R. A C (2003). Treating nerves: from anecdote to systematic review. JRSM 96: 432-435 [Full Text]  
• (2002). Evaluation and Treatment of Carpal Tunnel Syndrome Reviewed. JWatch Neurology 2002: 5-5 [Full Text]