General practice & primary care · UKMLA & AKT
Carpal tunnel syndrome
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Paraesthesia and numbness - thumb, index, middle finger, and radial half of ring finger (median nerve distribution); little finger spared
- Nocturnal pain and tingling - classically wakes the patient from sleep
- Flick sign - shaking/flicking the wrist relieves symptoms; highly specific for CTS
- Wrist and forearm pain - may radiate proximally up the forearm
- Weakness of abductor pollicis brevis - motor sign indicating more advanced disease
- Thenar muscle wasting - flattening of thenar eminence; sign of chronic, severe compression
- Tinel's sign - percussion over carpal tunnel at wrist crease reproduces tingling in median nerve distribution
- Phalen's test - maximal wrist flexion held for 60 seconds reproduces symptoms
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