title: [Diagnostic pitfalls in carpal tunnel syndrome].
abstract: BACKGROUND
  This review focuses on the main aspects of positive and differential diagnosis of carpal tunnel syndrome (CTS) in different clinical situations encountered in daily practice.
  
  
  BACKGROUND
  Authentic CTS can be discovered in situations, which alter the usual presentation or therapeutic management. This is the case for instance in pregnant women or in the elderly subject or with acute motor forms where CTS discloses a focal intratunnel disorder (neuroma, lipoma, arterial condition, bone disorder) or a general disease (hereditary neuropathy, amylosis). In certain situations, the clinical manifestations suggest a more proximal compression of the medial nerve (round pronator, Struthers arcade, or superficial flexor) or an inflammatory condition (mononeuritis, inflammatory demyelinising neuropathy). Locoregional disease may also be involved, for instance a plexus (thoracobrachial outlet syndrome, post-radiation plexitis) or radicular condition. The clinical presentation of diffuse polyneuropathy with initial manifestations involving the upper limb (ganglioneuropathies, polyradiculoneuritis, small-fiber neuropathies) may also be misleading. Finally central conditions can sometimes be confused with CTS.
  
  
  CONCLUSIONS
  A rigorous physical examination and an electroneuromyogram are determining to avoid diagnostic pitfalls.
authors.affiliation: Service de neurologie, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69004 Lyon, France. philippe.petiot@chu-lyon.fr
authors.forename: P
authors.initials: P
authors.lastname: Petiot
authors.forename: E
authors.initials: E
authors.lastname: Bernard
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000209:etiology; D002493:Central Nervous System Diseases / Q000175:diagnosis; D003711:Demyelinating Diseases / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D004576:Electromyography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D020423:Median Neuropathy / Q000175:diagnosis; D016472:Motor Neuron Disease / Q000175:diagnosis; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis