腕管综合征误诊为神经根型颈椎病的原因分析及对策OA

Objective To analyze the causes of misdiagnosis of carpal tunnel syndrome(CTS)as cervical radiculopathy(CR),and to provide practical evidence for reducing such misdiagnoses and optimizing diagnostic and treatment strategies in clinical practice.Methods A retrospective review was conducted on the clinical data of 52 patients initially diagnosed with CR but ultimately confirmed as CTS,who were admitted to the Department of Orthopedics,the 980th Hospital of the Joint Logistic Support Force of the PLA from January 2024 to December 2025.Based on history taking,physical examination,auxiliary examination results,and the misdiagnosis process,the core causes of misdiagnosis were summarized and corresponding measures were analyzed.Results All patients initially complained of discomfort in the neck and shoulders accompanied by numbness and pain in the hands.Among them,45 patients presented with numbness in the thumb,index finger,and middle finger alone,while 7 patients had numbness in the entire hand;44 patients experienced aggravated numbness at night,and 8 patients had significantly worsened symptoms after exertion.Based on personal history,symptoms,signs,and imaging findings,all 52 patients were diagnosed with CR.They received cervical traction,massage therapy,oral non-steroidal anti-inflammatory drugs,and neurotrophic medication.Symptoms did not significantly improve in 48 patients,while 4 patients experienced transient relief followed by rapid recurrence.Subsequently,through nerve conduction velocity and electromyography examinations,as well as efficacy verification after acupotomy for release of the transverse carpal ligament,a definitive diagnosis of CTS was established.The misdiagnosis duration ranged from 1 to 6 months(2.5±1.1 months).All patients achieved significant symptom relief after acupotomy for release of the transverse carpal ligament.Conclusion The symptoms and signs of CTS and CR overlap.Inadequate physical examination,imprecise interpretation of auxiliary tests,and a narrow clinical mindset are the main causes of misdiagnosis.Clinicians should strengthen the differential diagnostic capability of these two diseases and make comprehensive judgments based on history,specialized physical examination,neurophysiological findings,and imaging results to effectively reduce the misdiagnosis rate.