title: Unilateral carpal tunnel syndrome caused by an occult ganglion in the carpal tunnel: a report of two cases.
abstract: Carpal tunnel syndrome (CTS) usually presents bilaterally and a secondary nature should be suspected in patients with unilateral symptoms, especially those with a long-standing history, and when the symptomatic hand shows severe neurophysiologic impairment, while the contralateral hand is neurophysiologically intact. Space-occupying lesions are known to cause CTS and the incidence of space-occupying lesions in unilateral CTS is higher than that of bilateral CTS. It is easy to detect a mass when it is palpable; however, occult lesions are usually overlooked. Whenever a patient presents with unilateral symptoms and unilateral neurophysiologic impairment, the possibility of a space-occupying lesion compressing the median nerve should be kept in mind in the differential diagnosis. This study presents two cases with an occult ganglion in the carpal tunnel compressing the median nerve and causing unilateral symptoms of CTS. We stress on the importance of imaging studies in patients with unilateral symptoms that are usually not used in CTS. The reported patients were evaluated and magnetic resonance images revealed an intratunnel space-occupying lesion.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Rumeli Hisari Cad. No. 62, Baltalimani, Sariyer, 34470 Istanbul, Turkey.
authors.forename: Merter
authors.initials: M
authors.lastname: Yalcinkaya
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Rumeli Hisari Cad. No. 62, Baltalimani, Sariyer, 34470 Istanbul, Turkey.
authors.forename: Yunus Emre
authors.initials: YE
authors.lastname: Akman
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Medicana International Istanbul Hospital, Beylikdüzü Cad. No. 3, Beylikdüzü, 34520 Istanbul, Turkey.
authors.forename: A Erdem
authors.initials: AE
authors.lastname: Bagatur
references.citation: J Hand Surg Br. 1998 Oct;23(5):603-6
references.pmid: 9821602
references.citation: J Hand Surg Eur Vol. 2012 Jan;37(1):14-9
references.pmid: 21825010
references.citation: J Hand Surg Br. 1993 Dec;18(6):748-9
references.pmid: 8308434
references.citation: AJR Am J Roentgenol. 2000 Dec;175(6):1721-5
references.pmid: 11090410
references.citation: J Hand Surg Br. 2006 Feb;31(1):68-71
references.pmid: 16257100
references.citation: Orthop Clin North Am. 1996 Apr;27(2):345-54
references.pmid: 8614583
references.citation: Electromyogr Clin Neurophysiol. 2001 Dec;41(8):451-6
references.pmid: 11776657
references.citation: J Bone Joint Surg Br. 2001 Jul;83(5):655-8
references.pmid: 11476299
references.citation: Radiology. 1989 Jun;171(3):749-54
references.pmid: 2541464
references.citation: J Hand Surg Am. 1988 Sep;13(5):763-5
references.pmid: 3241055
references.citation: Muscle Nerve. 1997 Dec;20(12):1477-86
references.pmid: 9390659