{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:52:52Z","timestamp":1792029172191,"version":"4.4.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Usually caused by compression of the wrist's median nerve, carpal tunnel syndrome (CTS) is one of the most common types of peripheral neuropathy. Tophi deposited under the epineurium of the median nerve compress the median nerve, leading to CTS, which is very rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report a 64-year-old man with a history of tophaceous gout who presented with typical CTS symptoms and was admitted to our hospital. A physical examination revealed swelling over the right volar aspect of the carpal region, and he was unable to flex due to subcutaneous rigidity. Tinel's sign and Phalen's maneuver were positive. Electrophysiological studies confirmed the diagnosis of CTS. A carpal tunnel release and surgery to remove the gouty tophus of the right wrist were performed when serum uric acid levels were within normal limits (5.8\u2005mg\/dl). During the operation, tophi deposited under the epineurium of the median nerve were found, and the tophi were completely removed. Operative findings confirmed the diagnosis of CTS due to gout. The patient recovered uneventfully without signs of recurrence of gout and CTS symptoms during a 1-year follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A gouty tophus is an uncommon cause of CTS, and CTS may be caused by gouty tophi if there is evidence of extrinsic compression of the median nerve or symptoms emanating from the carpal tunnel.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.942062","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T18:03:23Z","timestamp":1673028203000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Carpal tunnel syndrome caused by tophi deposited under the epineurium of the median nerve: A case report"],"prefix":"10.3389","volume":"9","author":[{"given":"Wenzhong","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingbo","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiang","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1016\/S1474-4422(16)30231-9","article-title":"Carpal tunnel syndrome: clinical features, diagnosis, and management","volume":"15","author":"Padua","year":"2016","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"655","DOI":"10.2214\/ajr.175.3.1750655","article-title":"Carpal tunnel syndrome caused by tophaceous gout: CT and MR imaging features in 20 patients","volume":"175","author":"Chen","year":"2000","journal-title":"Am J Roentgenol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"193","DOI":"10.17085\/apm.2020.15.2.193","article-title":"Carpal tunnel syndrome caused by thrombosed persistent median artery: a case report","volume":"15","author":"Jeon","year":"2020","journal-title":"Anesth Pain Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1539\/joh.2017-0247-CS","article-title":"Carpal tunnel syndrome after an electrical injury: a case report and review of literature","volume":"60","author":"Wong","year":"2018","journal-title":"J Occup Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"E79","DOI":"10.1111\/ans.15306","article-title":"Carpal tunnel syndrome caused by space-occupying lesion: case report","volume":"90","author":"Crepaldi","year":"2020","journal-title":"ANZ J Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"105647","DOI":"10.1016\/j.ijscr.2021.105647","article-title":"Carpal tunnel syndrome caused by a giant lipoma of the hand: a case report","volume":"80","author":"Tellier","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.hansur.2018.10.241","article-title":"Carpal tunnel syndrome due to hibernoma of the wrist: case report","volume":"38","author":"Bouya","year":"2019","journal-title":"Hand Surg Rehabil"},{"key":"B8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.25259\/SNI_765_2020","article-title":"Carpal tunnel syndrome caused by the entrapment of a bifid lanz IIIA type anatomical variant of median nerve: a case report and systematic literature review","volume":"12","author":"Corte","year":"2021","journal-title":"Surg Neurol Int"},{"key":"B9","doi-asserted-by":"publisher","first-page":"862","DOI":"10.3928\/0147-7447-20040801-23","article-title":"Carpal tunnel syndrome due to tophaceous gout","volume":"27","author":"Rich","year":"2004","journal-title":"Orthopedics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e6245","DOI":"10.1097\/MD.0000000000006245","article-title":"A repeated carpal tunnel syndrome due to tophaceous gout in flexor tendon: a case report","volume":"96","author":"Lu","year":"2017","journal-title":"Medicine"},{"key":"B11","doi-asserted-by":"publisher","first-page":"279","DOI":"10.12998\/wjcc.v6.i9.279","article-title":"Chronic carpal tunnel syndrome caused by covert tophaceous gout: a case report","volume":"6","author":"Luo","year":"2018","journal-title":"World J Clin Cases"},{"key":"B12","doi-asserted-by":"publisher","first-page":"298","DOI":"10.3109\/14397595.2013.874753","article-title":"Bilateral carpal tunnel syndrome due to gouty tophi: conservative and surgical treatment in different hands of the same patient","volume":"25","author":"Onuma","year":"2015","journal-title":"Mod Rheumatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1038\/nrrheum.2013.120","article-title":"Crystal arthritis. Intensive urate-lowering therapy improves structural joint damage in patients with tophaceous gout","volume":"9","author":"Buckland","year":"2013","journal-title":"Nat Rev Rheumatol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.942062\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T18:03:25Z","timestamp":1673028205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.942062\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,6]]},"references-count":13,"alternative-id":["10.3389\/fsurg.2022.942062"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.942062","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,6]]},"article-number":"942062"}}