• Carpal tunnel: space between flexor retinaculum (transverse carpal ligament) and carpal bones, through which median nerve travels
• Syndrome is an entrapment neuropathy
• Symptoms due to compression of median nerve by trauma, masses within canal (hemangioma, lipoma, ganglia), rheumatoid arthritis, amyloidosis

• Pain, often accompanied by parasthesia in distribution of median nerve
• Rarely wasting of thenar muscles

• 48 year old man with giant lipoma causing carpal tunnel syndrome (Pan Afr Med J 2011;9:29)
• 64 year old woman with periarticular calcification causing acute carpal tunnel syndrome (J Orthop Surg (Hong Kong) 2009;17:234)

• Surgical; division of transverse carpal ligament

Untreated

Lesion with incision marking

Giant lipoma stretching median nerve

2 years follow up

• Nerve appears constricted and pale

Resected giant lipoma

• Transverse carpal ligament shows nonspecific fibrosis

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