Objective
To evaluate a child who presented bilateral hypoplasia of the thenar eminences and clumsy hands without sensory loss or nocturnal pain.

Method
A careful history taking, physical examination, plain X-ray and electrophysiologic examination.

Result: No familial history nor a systemic etiology were identified in this patient. Physical examination revealed a marked flattening of both thenar eminences and weakness of the abductor pollicis brevis and opponens pollicis of both hands. There was no sensory loss nor neurologic abnormality. X-rays of the hands showed thin both proximal end of the first metacarpals. The electrophysiologic examination showed electreical silence of both thenar eminences. History taking, physical examination, X-ray findings and electrophysiologic findings were all compatible with the Cavanagh syndrome.

Conclusion
A careful history taking, physical examination and electrophysiologic examination are improtant for the diagnosis of congenital carpal tunnel syndrome.