Carpal tunnel syndrome - ultrasound

Case contributed by A.Prof Frank Gaillard

See below

Case Discussion

Findings suggestive of carpal tunnel syndrome on the right with distortion and flattening of the median nerve.

In imaging median nerve syndromes, ultrasound is useful in examining CTS, potentially revealing, in fully developed cases, a triad of:

  • palmar bowing of the flexor retinaculum (>2 mm beyond a line connecting the pisiform and the scaphoid)
  • distal flattening of the nerve
  • enlargement of the nerve proximal to the flexor retinaculum

Enlargement of the nerve distal to the flexor retinaculum seems to be the most sensitive and specific criterion, but what cut-off value for pathological size remains debated; normal cross-sectional area is given at 9-11 mm², but the range of sizes deemed pathological is wide. 

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Case information

rID: 8164
Published: 16th Jan 2010
Last edited: 27th Nov 2015
Inclusion in quiz mode: Included

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