Changing Hand Color after Carpal Tunnel Injection
A 43-year-old woman presented to the neuromuscular clinic with a 6-month history of mild weakness and progressive paresthesia in the thumb and index, middle, and ring fingers of the left hand. For treatment of carpal tunnel syndrome, she received an injection of 0.33 ml of glucocorticoid into the left carpal tunnel and quickly reported feeling what she described as an “odd sensation.” Within 5 minutes after the injection, the skin overlying the affected thumb and fingers and adjacent palm extending to the palmar ulnar surface became red. The vasomotor disturbance was presumably related to the irritation of autonomic fibers in the median nerve. Within 20 minutes, these changes resolved without intervention. On follow-up 1 month after the injection, the paresthesia had resolved.