Acute progressive bilateral carpal tunnel syndrome associated with remitting seronegative symmetrical synovitis with pitting edema syndrome: A case report
Acute progressive bilateral carpal tunnel syndrome associated with remitting seronegative symmetrical synovitis with pitting edema syndrome: A case report
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DOI：
10.1177/2309499019893079
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发表时间：
2020-01-01
影响因子：
1.6
通讯作者：
Morioka, Hideo
中科院分区：
文献类型：
--
作者：
Okuma, Kentaro;Furuhata, Ryogo;Morioka, Hideo
腕管综合征（CTS）与缓解性血清阴性对称性滑膜炎伴凹陷性水肿（RS3PE）综合征（一种老年发病的风湿病）之间的关系尚不完全清楚。在此，我们报告一例由RS3PE综合征引起的急性CTS。一名84岁男性因突然发作的严重正中神经神经痛和双手凹陷性水肿而就诊。计算机断层扫描显示屈曲肌腱周围低密度区和腕管正中神经受压。迅速进展的无法忍受的神经痛和麻痹需要紧急解除左手腕管。手术后，我们考虑到RS3PE综合征的可能性，并开始给药强的松龙。凹陷性水肿及神经痛均有改善。在本例中，影像学和术中结果提示，与RS3PE综合征相关的屈肌腱滑膜炎产生的积液迅速增加了腕管内压，导致急性CTS和紧急手术。
The association between carpal tunnel syndrome (CTS) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, an elderly onset rheumatic disease, is not fully understood. Here, we describe a case of acute CTS caused by RS3PE syndrome. An 84-year-old man visited the hospital with sudden onset of severe neuralgia in the median nerve and pitting edema in both hands. Computed tomography showed low-density areas around the flexor tendons and median nerve compression in the carpal tunnel. Rapidly progressing intolerable neuralgia and paralysis required urgent carpal tunnel release in the left hand. After surgery, we considered the possibility of RS3PE syndrome and started the administration of prednisolone. The pitting edema and neuralgia improved. In this case, imaging and intraoperative findings suggest that the effusion generated from flexor tenosynovitis associated with RS3PE syndrome increased the internal pressure in the carpal tunnel rapidly, which led to acute CTS and urgent surgery.