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Median nerve penetration by a persistent median artery and vein mimicking carpal tunnel syndrome
Author(s) -
Stavros Kara,
Paik David,
Motiwala Rajeev,
Weinberger Jesse,
Zhou Lan,
Shin Susan
Publication year - 2016
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.24974
Subject(s) - medicine , carpal tunnel syndrome , median nerve , ultrasound , forearm , carpal tunnel , electromyography , outpatient clinic , surgery , nerve conduction , radiology , physical medicine and rehabilitation
: 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