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LETTERS: W Angus Wallace, Andrew C Hayward, Tim Davies, and J W H H Dammers Injection with methylprednisolone for carpal tunnel syndrome BMJ 2000; 320: 645a [Full text]

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Is Thoracic Outlet Syndrome missed

Carlos A Selmonosky   (5 March 2000)

The Presentation Known as "Carpal Tunnel Syndrome"

J P Driver-Jowitt   (10 March 2000)

Is Thoracic Outlet Syndrome missed 5 March 2000
Carlos A Selmonosky Gilmer Medical Center Send response to journal: Re: Is Thoracic Outlet Syndrome missed	Were these patients tested to rule out Thoracic Outlet Syndrome being present?. Double crush injury phemomenon,being TOS the proximal compression neuropathy,can explain the contradictory results.If TOS is not ruled out.
The Presentation Known as "Carpal Tunnel Syndrome" 10 March 2000
J P Driver-Jowitt, Orthopaedic Surgeon Cape Town, South Africa Send response to journal: Re: The Presentation Known as "Carpal Tunnel Syndrome"	The presentation known as "Carpal Tunnel Syndrome" is probably a poly -factorial pathology. Unlike the other entrapment neuropathies, it can be confounded by tenosynovitis, and indeed many of the symptoms are as much those of tendon pathology, as of nerve. Factors at the level of the thoracic outlet might come into play, and what we now know as CTS was successfully treated by scalenus decompression as the method of choice in the mid last century. There are certainly different profiles of presentation, varying from the nocturnal, or that associated only with pregnancy, to the constant and severely symptomatic presentation with rapid muscle atrophy. Any claims for a single successful treatment of CTS will only have a validity if this matched against a more precise subset of the different forms of CTS causation.