Common and Less Common Upper Extremity Entrapments

So my portion of this is gonna be related to something fairly basic, but we'll, we'll talk about some interesting stuff here with carpal tunnel syndrome.

So quick learning objectives.

Recognize, recognize carpal tunnel patterns, mimics, red flags.

Understand risk factors, causation, disease severity.

Um, discuss the diagnostic performance examination, uh, electrodiagnostics, and ultrasound.

And then discussing, um, evidence-based management referral pathways.

So real briefly, some epidemiology here.

Uh, three to five percent, uh, incidence in the general adult, um, excuse me, prevalence in adult population.

I, I kinda feel like, you know, even though this is from the literature, I kinda feel like our little neck of the woods is significantly higher based off of the, um, age of our population, but also the, um, uh, the vocations that are utilized here and have been for many, many years.

So I think ours is probably a lot higher, probably closer to fifteen, maybe even twenty percent.

It's, it's pretty, pretty common.

We see it a lot.

Technically, women more than men.

Again, a lot of that has to do, uh, with, uh, um, uh, wrist shape, um, and then a lot of times midlife.

So we used to say fif- this to seventh decades of life.

I, I think it's getting a lot earlier, uh, with the advent of phones and computers and all these different things.

We're looking at forty to sixty now.

Um, so who-- what, what are some of these r- main risk factors? Um, there's some metabolic ones, so obviously obes-obesity, diabetes.

Diabetes has a component where, you know, even if they don't have a full-blown neuropathy, the nervous system will be just not quite as resilient and more likely, um, to get some little compression neuropathies.

Um, hormonal flu-related pregnancy is the classic one, but other endocrine disorders as well.

Inflammatory and structural issues, so with ar- rheumatoid arthritis, tenosynovitis, wrist traumas, these kinds of things are really, really important to factor in.

And then lastly, and probably most importantly and most commonly, occupational exposures, so forceful, repetitive hand use, and especially with vibration.

Um, some brief anatomy, carpal tunnel space.

Um, so we've got the median nerve there.

That's the yellow circle surrounded by about nine tendons.

So my portion of this is gonna be related to something fairly basic, but we'll, we'll talk about some interesting stuff here with carpal tunnel syndrome.

So quick learning objectives.

Recognize, recognize carpal tunnel patterns, mimics, red flags.

Understand risk factors, causation, disease severity.

Um, discuss the diagnostic performance examination, uh, electrodiagnostics, and ultrasound.

And then discussing, um, evidence-based management referral pathways.

So real briefly, some epidemiology here.

Uh, three to five percent, uh, incidence in the general adult, um, excuse me, prevalence in adult population.

I, I kinda feel like, you know, even though this is from the literature, I kinda feel like our little neck of the woods is significantly higher based off of the, um, age of our population, but also the, um, uh, the vocations that are utilized here and have been for many, many years.

So I think ours is probably a lot higher, probably closer to fifteen, maybe even twenty percent.

It's, it's pretty, pretty common.

We see it a lot.

Technically, women more than men.

Again, a lot of that has to do, uh, with, uh, um, uh, wrist shape, um, and then a lot of times midlife.

So we used to say fif- this to seventh decades of life.

I, I think it's getting a lot earlier, uh, with the advent of phones and computers and all these different things.

We're looking at forty to sixty now.

Um, so who-- what, what are some of these r- main risk factors? Um, there's some metabolic ones, so obviously obes-obesity, diabetes.

Diabetes has a component where, you know, even if they don't have a full-blown neuropathy, the nervous system will be just not quite as resilient and more likely, um, to get some little compression neuropathies.

Um, hormonal flu-related pregnancy is the classic one, but other endocrine disorders as well.

Inflammatory and structural issues, so with ar- rheumatoid arthritis, tenosynovitis, wrist traumas, these kinds of things are really, really important to factor in.

And then lastly, and probably most importantly and most commonly, occupational exposures, so forceful, repetitive hand use, and especially with vibration.

Um, some brief anatomy, carpal tunnel space.

Um, so we've got the median nerve there.

That's the yellow circle surrounded by about nine tendons.