Self-inflicted wrist injury (ultrasound)

Case contributed by Maulik S Patel
Diagnosis certain

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

US of the Rt wrist was done

ultrasound

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 fibers 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 fibers 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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