Biomaterial Database

[Double tunnel syndrome of the upper limb in tophaceous gout. Apropos of a case]. 1994

P Jacoulet

Polyclinique des Lices, Chemin du Corporal, Castres.

Association of two tunnel syndromes secondary to tophaceous gout is uncommon. This article presents a case of ulnar and carpal tunnel compression. It concerns a 71 year old man with gout and treated for that condition. He presented with paraesthesiae in the fingers and loss of muscular strength in right hand. Physical examination discovered two masses, one in the epitrochlear groove, the other in the olecranon bursa; a severe ulnar palsy and a carpal tunnel syndrome. Neurolysis of both ulnar and median nerves was performed. After 2 years follow-up, paraesthesiae disappeared but atrophy of ulnar intrinsic muscles remained unchanged. The literature is reviewed. Carpal tunnel syndrome is well known in gout (28 reported cases), and is secondary to gouty tenosynovitis. Ulnar tunnel syndrome has been described once by Akizuki in 1984. The combination of the two conditions has not been previously been reported. In our case, median nerve compression was secondary to gouty synovitis but also to a bulky tophus from the floor of the carpal tunnel.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008475	Median Nerve	A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand.	Median Nerves,Nerve, Median,Nerves, Median
D009408	Nerve Compression Syndromes	Mechanical compression of nerves or nerve roots from internal or external causes. These may result in a conduction block to nerve impulses (due to MYELIN SHEATH dysfunction) or axonal loss. The nerve and nerve sheath injuries may be caused by ISCHEMIA; INFLAMMATION; or a direct mechanical effect.	Entrapment Neuropathies,Nerve Entrapments,External Nerve Compression Syndromes,Internal Nerve Compression Syndromes,Nerve Compression Syndromes, External,Nerve Compression Syndromes, Internal,Compression Syndrome, Nerve,Compression Syndromes, Nerve,Entrapment, Nerve,Entrapments, Nerve,Nerve Compression Syndrome,Nerve Entrapment,Neuropathies, Entrapment,Neuropathy, Entrapment,Syndrome, Nerve Compression,Syndromes, Nerve Compression
D010292	Paresthesia	Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation.	Dysesthesia,Formication,Paresthesia, Distal,Paresthesia, Painful,Distal Paresthesia,Distal Paresthesias,Dysesthesias,Formications,Painful Paresthesia,Painful Paresthesias,Paresthesias,Paresthesias, Distal,Paresthesias, Painful
D002349	Carpal Tunnel Syndrome	Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45)	Compression Neuropathy, Carpal Tunnel,Entrapment Neuropathy, Carpal Tunnel,Amyotrophy, Thenar, Of Carpal Origin,Median Neuropathy, Carpal Tunnel,Carpal Tunnel Syndromes,Syndrome, Carpal Tunnel,Syndromes, Carpal Tunnel
D005385	Fingers	Four or five slender jointed digits in humans and primates, attached to each HAND.	Finger
D006073	Gout	Metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of URIC ACID calculi.	Gouts
D006225	Hand	The distal part of the arm beyond the wrist in humans and primates, that includes the palm, fingers, and thumb.	Hands
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly