Median nerve traumatic neuroma

Case contributed by Dr Maulik S Patel

Presentation

Penetrating injury to the volar side of the left mid-third forearm 2 weeks before the presentation. Complaining of the weakness of the thumb, index, and middle fingers.

Patient Data

Age: 40 years
Gender: Male
Ultrasound

There is a focal area of hypoechoic thickening, loss of fascicular pattern of the median nerve in the mid-forearm scar region. The nerve shows continuity. The short-axis image shows the involvement of full thickness of the nerve. There is no perineural collection.

There is a curvilinear hypoechoic scar in the overlying flexor carpi radialis and subcutaneous fat reaching the skin.

Case Discussion

An adult male had a penetrating metal injury to the left volar mid-forearm region. He developed weakness of the fingers innervated by the median nerve. Nerve conduction study also suggested median neuropathy. Ultrasound shows a traumatic neuroma-in-continuity involving the median nerve at the scar region.

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