Carpal tunnel syndrome - with inverted notch sign

Case contributed by Dr Maulik S Patel


Tingling in fingers - Few wks.

Patient Data

Age: about 40 - 45 yrs
Gender: Female

There is bifercation of median nerve before carpal tunnel. It is a normal variant.

Absence of persistant median artery is noted.

Combined Cross sectional area of two branches -   Normal combined upto 11 mm

Proximal to tunnel - Ulnar division - 3 mm     + radial division - 3 mm  - Total - 6 mm

Distal  to tunnel     - Ulnar division - 8 mm      + radial division - 6 mm  - Total - 14 mm

Tapering is seen distal to tunnel in both divisions - Called as inverted notch sign

No mass lesion is seen.

No tenosynovitis is seen.


Case Discussion

Nerve Tapering is seen distal to tunnel in both ulnar and radial divisions - Called as inverted notch sign.

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Case information

rID: 29710
Published: 16th Jun 2014
Last edited: 18th Dec 2015
Inclusion in quiz mode: Included

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