Misdiagnosis in carpal tunnel syndrome: amyloidosis and other red flags. A narrative review

Introduction Carpal tunnel syndrome (CTS) involves the entrapment of the median nerve at the wrist. Despite acceptable sensitivity and specificity in diagnostics tests, errors persist, leading to unsuccessful treatments, especially when CTS is an early sign of other conditions. Content This review aims to identify red flags that may manifest as CTS or coexist with it, and to describe their clinical presentations. Summary A PubMed search (2000–2025) yielded 622 articles, with 24 included in the review. Of these, 12 articles explored CTS and amyloidosis, three with neurological pathologies, three with tumours, two with rheumatic diseases, one with Raynaud’s disease, one on CTS in children, and two with other conditions. Outlook Many conditions can be mistaken for CTS. Given its high prevalence, healthcare professionals must distinguish these to reduce surgical failures and improve early detection of conditions like cardiac amyloidosis or multiple sclerosis.