결핵성 건활액막염에 의한 수근관 증후군 2예 보고

Abstract

The carpal tunnel syndrome is the most common form of peripheral nerve entrapment syndromes. Its cause is usually idopathic resulting from disproportion between the carpal tunnel and volume of the content of the carpal tunnel. Causes of nerve compression syndromes in the carpal tunnel by means of mass effects, include ganglions, tumors, maluninon after distal radioulnar fractures, lunate dislocation, hypertrophy of tenosynoviums. Among these, infections and tuberculosis as cause of the carpal tunnel syndromes are very rare. Tuberculous tenosynovitis also can cause edema and mass in carpal tunnel, so volume of contents in carpal tunnel increase and finally carpal tunnel syndrome can be developed. We experienced two cases of carpal tunnel syndrome caused by tuberculous tenosynovitis which showed diffuse swelling and tenderness around the wrist. The carpal tunnel sydrome by nerve conduction velocity and median nerve compression by hypertrophied tenosynovium on magnetic resonance image were observed. Tuberculosis should be considered in the differential diagnosis of carpal tunnel syndrome with unexplained chronic tenosynovitis in the wrist. Its diagnosis may be missed unless a tissue specimen is analyzed by culture and pathologic evaluation. It\'s therapy should include excision of involved tenosynovium, open decompression of carpal tunnel, removal of inflammted tenosynovium and appropriate anti tuberculous chemotherapy.