A rare ultrasound finding in carpal tunnel syndrome
Mathieu Boudier-Reveret1, Meng-Ting Lin2, Chueh-Hung Wu2 1 Department of Physical Medicine and Rehabilitation, University of Montreal Health Center, Montreal, Canada 2 Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
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Correspondence Address: Mathieu Boudier-Reveret Department of Physical Medicine and Rehabilitation, University of Montreal Health Center, 3840, St-Urbain St., Montreal, QC, H2W 1T8 Canada
Source of Support: None, Conflict of Interest: None
How to cite this article: Boudier-Reveret M, Lin MT, Wu CH. A rare ultrasound finding in carpal tunnel syndrome. J Med Ultrasound 2020;28:56-7
A 60-year-old right-handed woman presented with right-hand numbness for 1 year mainly while riding her motorcycle or at night. She had no known diabetes mellitus or thyroid disorder. Electrodiagnostic study revealed prolonged distal motor latency (4.54 ms; distance between the stimulation and recording sites was 7 cm) and slowing of sensory nerve conduction velocity at the finger–wrist (35.4 m/s) and palm–wrist segments (27.8 m/s) of the right median nerve (MN). Right median neuropathy at the level of the wrist was compatible with carpal tunnel syndrome.
She was referred to the PM and R ultrasound (US) clinic to receive US-guided perineural injection therapy of her right MN with 5% dextrose.
During the preliminary US scan of her right MN, a rare variant was found [Figure 1], [Figure 2] and [Video 1]. She received right MN perineural injection as planned [Figure 3].
Figure 1: Ultrasound of the right median nerve within the carpal tunnel, transverse axis. FCR: Flexor carpi radialis tendon, FDS: Flexor digitorum superficialis tendons, FDP: Flexor digitorum profundus tendons, FPL: Flexor pollicis longus tendon
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