Interesting paper for anyone speculating on the impact of hypothyrodism in the development of carpal tunnel syndrome.
(Some of the pictures may not appeal to anyone waiting for surgery on their carpal tunnels...)
COMPARATIVE HISTOPATHOLOGIC EVALUATION OF DIABETIC, HYPOTHYROID AND IDIOPATHIC CARPAL TUNNEL SYNDROME
Figen Taser1, Ayse Nur Deger2, Hakkı Deger3
1Dumlupinar University Medical Faculty, Anatomy, Kutahya,
2Dumlupinar University Medical Faculty, Pathology, Kutahya,
3DPU-Evliya Celebi Training Hospital, Neurosurgery, Kutahya,
Current study planned to investigate histologic findings and differences in carpal tunnel syndrome (CTS) with diabetes mellitus, thyroid disease and idiopathic CTS patients.Material and Methods:Subsynovial connective tissue samples of 51 idiopathic CTS patients, 58 patients with diabetes mellitus and CTS, 16 patients with hypothyroidism and CTS were evaluated for this study. The histopathologic examination parameters were number of fibroblasts, size of collagen fibers, vascular changes (vascular proliferation, intimal thickening and changes of vessel structures), edema and inflammatory infiltration.
Non-inflammatory fibrosis was observed in subsynovial connective tissue when general histomorphological evaluation in majority of tissue samples taken from all three patient groups. Number of fibroblasts, collagen fiber diameter and lengths were found statistically different at diabetic CTS patients when compared with other both groups. Considering the overall results, neovascularization in subsynovial connective tissue is observed significantly more intense in the cases of diabetic CTS and severe edema is found in the cases of hypothyroidism and CTS.
Increased pressure of carpal tunnel may be as a result of reduction of the space size or increase in the volume of tunnel contents depending on cause such as fibrosis or edema with different etiopathogenesis. The better understanding of the causes of this entrapment neuropathy appears to be helpful to physicians and these causes have to take into consideration during preoperative evaluation.
Full paper available here: