Acute carpal tunnel syndrome.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 15. J Am Acad Orthop Surg. 2021 May 15;29(10):e488-e496. doi: 10.5435/JAAOS-D-20-01146. Orthopaedic Manifestations of Amyloidosis. Zhang D(1), Makhni MC, Kang JD, Blazar P. Author information: (1)From the Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA (Zhang, Makhni, Kang, and Blazar), and the Harvard Medical School, Boston, MA (Zhang, Makhni, Kang, and Blazar). Amyloidosis is a disorder of misfolded proteins in human tissues, which can result in morbid cardiac and neurological disease. Historically, the utility of tissue biopsy during orthopaedic procedures to detect amyloidosis has been limited because no disease-modifying therapies were available; however, new drug therapies have recently emerged for the treatment of amyloidosis. Although these novel pharmaceuticals show promise for slowing disease progression, they are primarily effective in the early stages of amyloidosis, underscoring the importance of early diagnosis. Common orthopaedic manifestations of amyloidosis include carpal tunnel syndrome, trigger finger, spontaneous distal biceps tendon rupture, rotator cuff disease, and lumbar spinal stenosis. Carpal tunnel syndrome is frequently the earliest manifestation of amyloidosis, on average preceding a formal diagnosis of amyloidosis by over four years. By recognizing the constellation of musculoskeletal symptoms in the patient with amyloidosis, orthopaedic surgeons can play an active role in patient referral, early detection of systemic disease, and prompt initiation of disease-modifying treatment. There may be a role for selective biopsy for amyloid deposition in at-risk patients during routine orthopaedic procedures. Copyright © 2021 by the American Academy of Orthopaedic Surgeons. DOI: 10.5435/JAAOS-D-20-01146