Cystic Hygroma in a Dental Hygienist Reporting With Carpal Tunnel Syndrome: A Case Report.

OBJECTIVE

This purpose of this case report is to describe the chiropractic management of a patient who presented with symptoms of hand neuropathy.

CLINICAL FEATURES: A 35-year-old woman presented with a 6-month history of numbness and tingling in the first and second digits of the right hand. Visual inspection revealed a large golf ball-like mass in the patient's right lower neck region. Orthopedic assessment revealed a Tinel's sign at the right carpal tunnel, positive Allen's maneuver, present flick sign, and diminished right radial pulse strength. Advanced diagnostic imaging had been taken previously at the ages of 11 and 24 years, and showed the presence of cystic hygroma in the patient's right axilla and lower neck region.

INTERVENTION AND OUTCOME: The patient was treated using manipulative therapy to the thoracic spine, myofascial release therapy, and therapeutic ultrasound over the right carpal tunnel. Active home care included postural relief exercises and education about work-related ergonomics. Several functional and subjective improvements were seen within the first 2 weeks of treatment. Symptoms of right-hand numbness resolved after 8 treatments.

CONCLUSION

In this case, the chiropractor originally thought the patient's hand numbness was due to a cystic hygroma; however, this was later considered an incidental finding. The patient's symptoms seemed to respond to chiropractic management and reduced within 1 month.