allopurinol and Carpal-Tunnel-Syndrome

We encountered only three patients of carpal tunnel syndrome (CTS) due to tophaceous gout during 25 years of practice in a 'hand clinic' situated in a large metropolis in West India. In two patients, the CTS was bilateral, a rare occurrence in gout. There was an unwarranted delay (up to 9 years) in the diagnosis of both the ailments. In each case, the site of offending tophus was uniquely different.

Topics: Adult; Aged; Allopurinol; Carpal Tunnel Syndrome; Diagnosis, Differential; Drug Therapy, Combination; Follow-Up Studies; Glucocorticoids; Gout; Gout Suppressants; Humans; Male; Middle Aged; Prednisolone

The symptoms of a 62-year-old man with carpal tunnel syndrome resulting from poorly controlled gout subsided after the transverse carpal ligament was released surgically. At the time of the operation, the tophi were found to deposit on the median nerve rather than the transverse ligament, a situation reported only once before. The absence of gouty tenosynovitis in this patient was supported by the wound healing well without the chalky discharge that patients have had in previous reports.

Topics: Allopurinol; Carpal Tunnel Syndrome; Combined Modality Therapy; Gout; Humans; Indomethacin; Male; Median Nerve; Middle Aged; Neurologic Examination; Tenosynovitis

Bilateral carpal tunnel syndrome was observed in a 39-year-old female with gout. Until now carpal tunnel syndrome caused by gout has not been observed in females. Due to marked clinical symptoms neurolysis on the right side had to be performed. The course of the left hand affection was observed while on conservative treatment with a xanthine oxidase inhibitor. As such therapy is possible and successful, it is mandatory to diagnose carpal tunnel syndrome early in gout. Histology showed the cause of carpal tunnel syndrome to be uric acid tendovaginitis.

Topics: Adult; Carpal Tunnel Syndrome; Female; Gout; Humans; Xanthine Oxidase