AANEM Connect
Join this vibrant community of professionals eager to exchange ideas, share resources, and engage in meaningful discussions. Use this platform as a sounding board to seek advice for navigating challenging cases or career decisions, and receive expert guidance from generous peers who want to help you succeed.
Interesting ultrasound finding
I was hoping to get some advice on an ultrasound finding. The patient is a 50-year-old quite muscular male with a history of prediabetes presenting with typical CTS symptoms. Symptoms and electrodiagnostic findings were much more prominent on the non-dominant left side. Left side DL/amp = 11.9ms/3.5mV, right side = 5.6ms/8.9mV. Ultrasound of the left median nerve at the distal wrist crease showed intrusion of the FDS muscle belly into the carpal tunnel when opening the hand and extending the fingers. On short axis, the muscle belly displaces and appears to compress the median nerve. Left median CSA was 24 mm2, right was 15 mm2. See youtube video link below. I was able to find a 2012 case report by Terasnoudis with similar findings but otherwise didn't see much in a pubmed search. I have not seen this before and am not certain about its incidence in general or its relationship to CTS. Does anyone have experience with this? How have you managed such patients?
https://www.youtube.com/watch?v=QVyZuwsPChc
Dan
In order to comment on posts and view posts in their entirety, please login with your AANEM member account information.
I enjoy participating in the AANEM Connect Forum for a number of reasons. There are very fundamental questions posed on a frequent basis that cause me to pause and ask myself, ‘Why didn’t I think of that?’ Also, I continue to learn new things when others contribute their thoughts and experiences. Connect is an excellent opportunity for members to interact and to address any topic, including those that may not be discussed at an annual meeting or journal article.
Daniel Dumitru, MD, PhD