Cystic radio-lucency of carpal bones in haemodialysis patients An early indicator of the onset of carpal tunnel syndrome

Patients receiving haemodialysis for more than 10 years were selected for this study in order to clarify an apparent sequential association of cystic lesions of carpal bones and carpal tunnel syndrome. X-rays and computed tomographs of 138 hands of 69 patients revealed cystic radiolucency of carpal bones in 35% of the hands. Radiographs were classified into three groups: Group A-cyst growing, Group B-cyst not growing, and Group C-cyst absent. The prevalence of carpal tunnel syndrome was 100% ( 27 27) in Group A, 5.6% ( 1 18) in Group B, and 6.5% ( 6 93) in Group C. Growth of the cyst precedes the development of carpal tunnel syndrome by about 2 or 3 years. Growth of the bone cyst indicates that inflammation had already extended to the tenosynovium and median nerve. Cystic radio-lucency of the carpal bones appears to be a useful indicator of the onset of carpal tunnel syndrome.