TTR and lumbar spinal stenosis: Because ATTR amyloid deposits in the soft tissues, ligaments, joints and tendons, a comprehensive orthopedic history should be taken (Figure 2).3 Several common clinical conditions, including carpal tunnel syndrome, lumbar spinal stenosis, trigger finger, and bicep tendon rupture, are documented extracardiac manifestations of ATTRwt-CA.29,30,31,32,33,34 Bilateral carpal tunnel syndrome and lumbar spinal stenosis can precede the cardiac diagnosis by several years.