J Brachial Plex Peripher Nerve Inj 2008; 03(01): e92-e94
DOI: 10.1186/1749-7221-3-4
Case report
Chan et al; licensee BioMed Central Ltd.

A Guyon’s canal ganglion presenting as occupational overuse syndrome: A case report[*]

Jeffrey CY Chan
1   Department of Plastic, Reconstructive and Hand Surgery, University Hospital Galway, Galway, Ireland
,
William H Tiong
1   Department of Plastic, Reconstructive and Hand Surgery, University Hospital Galway, Galway, Ireland
,
Michael J Hennessy
2   Department of Neurology, University Hospital Galway, Galway, Ireland
,
John L Kelly
1   Department of Plastic, Reconstructive and Hand Surgery, University Hospital Galway, Galway, Ireland
› Author Affiliations

Subject Editor:
Further Information

Publication History

18 October 2007

12 February 2008

Publication Date:
17 September 2014 (online)

Abstract

Background Occupational overuse syndrome (OOS) can present as Guyon’s canal syndrome in computer keyboard users. We report a case of Guyon’s canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS.

Case presentation A 54-year-old female secretary was referred with a six-month history of right little finger weakness and difficulty with adduction. Prior to her referral, she was diagnosed by her general practitioner and physiotherapist with a right ulnar nerve neuropraxia at the level of the Guyon’s canal. This was thought to be secondary to computer keyboard use and direct pressure exerted on a wrist support. There was obvious atrophy of the hypothenar eminence and the first dorsal interosseous muscle. Both Froment’s and Wartenberg’s signs were positive. A nerve conduction study revealed that both the abductor digiti minimi and the first dorsal interosseus muscles showed prolonged motor latency. Ulnar conduction across the right elbow was normal. Ulnar sensory amplitude across the right wrist to the fifth digit was reduced while the dorsal cutaneous nerve response was normal. Magnetic resonance imaging of the right wrist showed a ganglion in Guyon’s canal. Decompression of the Guyon’s canal was performed and histological examination confirmed a ganglion. The patient’s symptoms and signs resolved completely at four-month follow-up.

Conclusion Clinical history, occupational history and examination alone could potentially lead to misdiagnosis of OOS when a computer user presents with these symptoms and we recommend that nerve conduction or imaging studies be performed.

*This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


 
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