Carpal tunnel syndrome - with inverted notch sign
Clinical diagnosis of bilateral carpal tunnel syndrome. More on right side. 2 - 3 mths. Referred for Ultrasound.
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- multiple short and log axis images of carpal tunnel with focus on median nerve evaluation.
- mild increased cross sectional area of nerve is noted just proximal to tunnel about 12 - 13 mm.
- in the tunnel nerve cross section area: 7-10 mm.
- just distal to tunnel, nerve division is noted. Both ulnar and radial divisions show hypoechogenecity, increased cross sectional area (7-8 mm in each division) with loss of normal nerve echopattern.
- distally, tapening is noted in both divisions to the normal nerve diameter and with normal echogenecity.
- no solid / cystic mass lesion or tenosynovitis is noted in tunnel.
Ultrasound findings are positive for carpal tunnel syndrome.
There is the presence of inverted notch sign.
- Ultrasound of the Musculoskeletal system By S. Bianchi & C. Martinoli First Indian reprint 2007. Page No 460