Median nerve penetration by a persistent median artery and vein mimicking carpal tunnel syndrome |
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| Authors: | Kara Stavros MD David Paik MD Rajeev Motiwala MD Jesse Weinberger MD Lan Zhou MD Susan Shin MD |
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| Affiliation: | 1. Department of Neurology, Warren Alpert Medical School of Brown University, Providence, Rhode island, USA;2. Department of Radiology, Morristown Medical Center, Morristown, New Jersey, USA;3. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA |
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| Abstract: | Introduction: Carpal tunnel syndrome (CTS) is a common clinical syndrome seen in the outpatient setting that is easily confirmed by electrodiagnostic testing. Methods: We describe the case of a patient who presented with the classic symptoms and neurological examination for CTS, but had a normal nerve conduction study and electromyogram. Results: Neuromuscular ultrasound of the median nerve on the symptomatic side revealed penetration of the nerve by a persistent median artery and vein in the mid‐forearm, with a positive sonographic Tinel sign over this spot. This finding is an anatomical variation that has been described sparingly in the literature, mostly in cadavers. It has not been reported previously to be a mimic of CTS. Conclusions: This case demonstrates the diagnostic utility of neuromuscular ultrasound and the importance of considering an anatomical variation involving the median nerve in the differential diagnosis of CTS. Muscle Nerve 53: 485–487, 2016 |
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| Keywords: | carpal tunnel syndrome median nerve penetration median neuropathy neuromuscular ultrasound persistent median artery |
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