General practice & prim · UKMLA & AKT

Carpal tunnel syndrome

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise carpal tunnel syndrome — the full SA Note notes add investigations, management, complications and 10 practice questions.

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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