Carpal tunnel transthyretin amyloidosis case report comparing MRI findings with amyloid negative control

Amyloidosis is a systemic disorder characterized by extracellular protein deposition, with transthyretin amyloidosis being the most common subtype. Carpal tunnel syndrome is a frequent early manifestation, yet detailed MRI characterization of amyloid deposition in the wrist remains limited. We present MRI findings from one severe transthyretin amyloidosis case: a 65-year-old male with severe carpal tunnel syndrome secondary to transthyretin amyloidosis wild-type. The subject underwent wrist MRI using T1 and proton density sequences. This case demonstrated flexor tendon thickening, tenosynovial signal alteration, and striated signal changes within the tenosynovium. Through descriptive findings, MRI revealed potential patterns of amyloid involvement in carpal tunnel syndrome, highlighting prospective imaging biomarkers for characterizing transthyretin amyloidosis and supporting earlier consideration of cardiac involvement. These findings highlight the potential of MRIs in non-invasive amyloid characterization. As such, larger studies would be required to further validate these observations and integrate MRI into early amyloidosis diagnostic pathways.