Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. This syndrome
has various etiologies of which heterotopic ossification of the flexor retinaculum
is a rare cause. Ankylosing spondylitis (AS) is a systemic, progressive inflammatory
disease of unknown etiology that mainly affects the axial skeleton and rarely causes
peripheral neurological symptoms. A 48-year-old woman presented with numbness and
pain in her right hand. Ten years earlier, she was diagnosed with AS. Electrodiagnostic
evaluation revealed severe median nerve compression at the right wrist. The patient
underwent surgery for severe CTS. During the operation, the flexor retinaculum could
not be incised due to marked stiffness. Ossification of the flexor retinaculum was
seen, and the retinaculum was partially excised with an osteotome and Kerrison rongeur.
The patient's complaints resolved almost totally after the operation. AS is a common
systemic inflammatory disease that can produce heterotopic ossification of the flexor
retinaculum. Preoperative wrist computed tomography should be obtained in patients
with CTS and AS.
Key-words:
Ankylosing spondylitis - carpal tunnel syndrome - heterotopic ossification
