Presentation
About 4 weeks prior to the presentation, a patient had a self-inflicted cut injury to the palmar side of both wrists. He presented with a complaint of a reduced sensation of the right index finger.
Patient Data
Age: 35 years
Gender: Male
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Scar
- Axial plane.
- Proximal to the carpal tunnel
- Involves skin and subcutaneous tissue
- Hypoechoic, irregular shape
Palmaris longus tendon
- Full thickness tear with about 22 mm retraction
Median nerve
- Full-thickness but not full-width hypoechoic area replacing normal fascicular echopattern; resulting in hypoechoic nodule formation - neuroma
- Radial side fibres are spared.
- No retraction of ends.
- The nerve is normal in the carpal tunnel.
Palmar cutaneous branch of the median nerve
- Full-thickness and full-width hypoechoic area replacing normal fascicular echopattern resulting in hypoechoic nodule formation - neuroma (proximal to carpal tunnel)
- No retraction of ends.
- The nerve is normal in the carpal tunnel.
Flexor carpi radialis tendon
- Full-thickness, but not full-width injury. No retraction.
- Radial side fibres are spared.
The rest of the wrist examination is normal.
Case Discussion
The case shows ultrasound findings of nerve and tendon injuries in case of self-inflicted wrist trauma in an adult male.
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