Your patient has presented with symptoms of carpal tunnel syndrome, and the x-ray report suggests acromegaly. What should you do next?
For some months Dorothy, aged 48, has commented on her sore and stiff hands. Now she mentions symptoms suggestive of carpal tunnel syndrome, with morning numbness in the first and second fingers of her right hand extending into the thenar eminence (she is right handed).
You wonder if she has osteophytic changes compromising the carpal tunnel, and you arrange an x-ray.
The x-ray report comments on minor osteoarthritis, ‘arrow heading’ of the terminal digits and thickening of soft tissues. Acromegaly is mentioned as a potential cause.