title: Carpometacarpal subchondral cysts due to repetitive movements in shoemaker: a case report.
abstract: OBJECTIVE
  Subchondral carpometacarpal cysts are classic and almost pathognomonic lesions found in workers using vibrating instruments over prolonged periods of time.
  
  
  METHODS
  We present the case of a 53-year-old woman who worked for 30 years sewing shoe uppers, a task which required grasping firmly a pear-shaped handle awl and pushing it through the leather upper and the sole of the shoe, with combined flexion and supination movement of the wrist. After approximately 20 years of working, the patient noted gradual onset of paresthesias in the dominant (right) hand, with increasing difficulty in grasping the awl. Subsequent diagnosis of carpal tunnel syndrome was confirmed by electrophysiologic testing and its surgical release was performed. Nevertheless, hand pain, paresthesias and weakness persisted.
  
  
  RESULTS
  Ultrasound of the snuffbox tendons excluded DeQuervain tenosynovitis. Radiographic imaging of the symptomatic hand showed carpometacarpal subchondral cystic formations.
  
  
  CONCLUSIONS
  In addition to demonstrating the usefulness of radiographic imaging in patients with persistent hand pain post-carpal release, this case is important in illustrating that repetitive movements with high pressure over the palmar carpal area may cause bone cysts, even if the subjects do not use vibrating tools.
authors: Department of Public Health and Neuroscience, University of Pavia, Pavia, Italy. stefano.tonini23@libero.it
authors: Stefano
authors: S
authors: Tonini
authors: Stefano M
authors: SM
authors: Candura
authors: Andrea
authors: A
authors: Lanfranco
authors: N Valerio
authors: NV
authors: Mennoia
mesh_terms: D001845:Bone Cysts / Q000209:etiology* / Q000473:pathology; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D052737:Carpometacarpal Joints / Q000293:injuries* / Q000503:physiopathology; D012090:Cumulative Trauma Disorders / Q000503:physiopathology*; D005260:Female; D006230:Hand Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007558:Italy; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D011859:Radiography; D012775:Shoes; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology