Carpal tunnel syndrome in sarcoidosis

Sarcoidosis is a systemic disease that may affect the musculoskeletal syste m. An association between carpal tunnel syndrome (CTS) and sarcoidosis has not been demonstrated. Consecutive patients from the sarcoidosis clinic at our institution were questioned about history and symptoms of carpal tunnel syndrome: hand numbness and nocturnal paresthesias with relief of symptoms by shaking of the hands (flick sign). A physical exam was performed to eva luate for Tinel's and Phalen's signs. A comparison of the presence of arthr itis, prednisone treatment, spirometry, and number of organs involved with sarcoidosis was made in patients with a history or clinical findings of CTS versus those without. Eighty-nine patients were evaluated. Thirty-five pat ients (39%) had nocturnal paresthesias with a positive flick sign. Fourteen patients (16%) had physical findings of CTS. A history of CTS was present in 14 (16%) of the patients, four of which were documented by EMG. There wa s no significant difference between the frequency of prednisone treatment i n patients with or without CTS history, nocturnal paresthesias, or Phalen's sign. There were significantly fewer patients with a positive Tinel's sign who were receiving prednisone. There was a trend toward an increased frequ ency of wrist arthritis in patients with a history or clinical findings of CTS. There was no significant difference in disease severity, assessed by s pirometry or organ involvement, when comparing sarcoidosis patients with or without a history or clinical findings of CTS. Thirty-nine (44%) had sympt oms and/or signs of CTS. Even when we adjusted our sarcoidosis population f or other factors associated with CTS, the prevalence of symptoms and signs of CTS was much higher in our patient population than in studies of the gen eral population. Our findings suggest that CTS is common in sarcoidosis.