Carpal Tunnel Syndrome and Lumbar Spinal Stenosis: When to Suspect Amyloidosis and How to Proceed with the Diagnostic Work-up (PubMed, Brain Nerve) - Oct 14, 2026 - "These musculoskeletal manifestations may precede ATTR cardiomyopathy (ATTR-CM) by several years to more than a decade, serving as "red flags" that provide an opportunity for early diagnosis, particularly now that disease-modifying therapies (the TTR stabilizers tafamidis and acoramidis and the silencer vutrisiran) are available and are most effective when initiated early. This review summarizes, from the perspective of orthopaedic-neurology collaboration, when to suspect amyloidosis in patients with CTS and LSS and how to proceed with the diagnostic work-up, including intraoperative tissue biopsy with Congo red staining and typing, mandatory exclusion of AL amyloidosis, bone scintigraphy using non-biopsy diagnostic criteria, and TTR genotyping with genetic counseling. The review incorporates recent evidence and our institutional experience."
Journal • Review • Amyloidosis • Cardiomyopathy • Cardiovascular • Musculoskeletal Diseases • Orthopedics
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