Differential diagnosis
The differential diagnosis for symptoms suggestive of carpal tunnel syndrome:
- C6/7 radiculopathy
- there is localised neck pain, stiffness, exacerbation of symptoms on neck movement and atypical patterns of neurological involvement
- diabetic neuropathy – remember that diabetes is the commonest cause of mononeuropathy
- hypothyroidism
- osteoarthritis of the small joints of the hand - may coexist with carpal tunnel syndrome
- other peripheral neuropathies
- suspect when symptoms are present in both the arms and the legs or reflexes are lost or diminished, or both
- ulnar nerve compression
- seen in the distribution of the ulnar nerve
- inflammatory arthropathy of the small joints of the hand
- tendon disorders
- demyelinating disease
Reference:
- (1) Arthritis Research Campaign (June 2004). Hands On - Carpal Tunnel Syndrome.
- (2) Middleton SD, Anakwe RE Carpal tunnel syndrome. BMJ. 2014;349:g6437
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