In evaluating symptoms of carpal tunnel syndrome, which digit is first assessed for sensory loss?

• A. Fourth digit
• B. Second digit
• C. First digit
• D. Third digit

Answer: (C)

In the evaluation of carpal tunnel syndrome, assessing sensory loss typically begins with the first digit, also known as the thumb. The reason for this is rooted in the neural anatomy involved in carpal tunnel syndrome: the median nerve, which is affected in this condition, primarily innervates the sensory aspects of the thumb, index finger, middle finger, and part of the ring finger.

The first digit is often the most crucial in diagnosing carpal tunnel syndrome because patients frequently report numbness or tingling in the thumb as one of the earliest and most prominent symptoms. This pattern of sensory involvement occurs because the median nerve supplies sensation to the palmar surface of these digits, and therefore, changes in sensory perception in the thumb can serve as a reliable indicator of median nerve dysfunction.

Understanding this helps clinicians focus their evaluation effectively, as early identification of symptoms associated with the first digit can guide the overall assessment and management of carpal tunnel syndrome.