Coincidence of Carpal Tunnel Syndrome with Cervical Radiculopathy: Results from Multi-institutional International Database Analysis

Introduction: Unilateral pain, numbness, or tingling sensation in upper limb, are the most common complaints in outpatient’s visits. Two known diagnoses for these symptoms are carpal tunnel syndrome (CTS) and cervical radiculopathy (CR). Differentiating these two etiologies may be difficult and, because diagnosis of the two is often done by specialists in different fields, there is a risk of misattribution of symptoms. CTS incidence proportion in the whole database is 1.3 from 2002-2022. We aim to provide a base-estimate of the coincidence of CTS with CR.

Methods: Preliminary de-identified aggregate data was obtained utilizing TriNetX, a federated health research network providing access to statistics on electronic medical records that included seventy health care organizations within the US and two other countries. Patients with the ICD-10 code for CR (ICD-10 M54.12, ICD-9 723.4) who underwent surgery (CPT: 22548, 22551, 63075, 63081, 63085, 22856, 22857, 63015, 63045, 63265, 63020, 63040, 63075, 63076, 22595, 22600) were queried within the database from 2002 to 2022.

Results: Of the 61,657 patients who underwent surgery for a CR, 51.0% were male, 81.0% were white, and the mean age was 60.3 (SD: ±11.9) years. 21.0% had BMI>25 and 19.0% were diagnosed with type II diabetes mellitus. Of all patients, 15.0% were diagnosed with CTS before being diagnosed with CR. 73.0% of CTS diagnoses were made within two years before CR diagnosis.

Conclusion : In this cohort approximately 1 in 6 were initially diagnosed with CTS. It is yet to be determined whether this represents misdiagnosis of CTS in patients with a CR or simply elevated co-incidence in this patient population. Understanding the likelihood of the other considerations in the differential diagnosis for anyone diagnosed with CTS aids in the establishment of more accurate diagnosis and management.