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Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper limb. Although most cases are idiopathic, it can occur due to various causes including an alteration of anatomical dimension of the carpal tunnel. CTS can be diagnosed mostly by clinical findings and electrodiagnostic test. As a result, the confirmation of structural change of carpal tunnel may be delayed as basic radiologic examinations such as simple radiography of the wrist are not performed. We confirmed carpal malalignment due to dorsal intercalated segmental instability on simple radiography of a patient with CTS whose symptoms did not improved by conservative managements. He had symptoms for more than 2 years, but had never undergone simple radiography of the wrist. Because structural changes of the carpal tunnel could be the main reason for CTS and affect the whole treatment process, the physician should always check standard radiography of the wrist before determining how to treat the patient.

Carpal Tunnel Syndrome due to Dorsal Intercalated Segmental Instability of the Wrist