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Thrombosis of persistent median artery

Case contributed by Dr Maulik S Patel

Presentation

Presented with the non-traumatic onset of the right palmar region pain for the last few days. Referred for an ultrasound.

Patient Data

Age: 35 years
Gender: Female
Ultrasound

Median nerve

  • Bifid nerve - a variant.
  • The combined cross-sectional area of two divisions - 7 mm2  (normal up to 11 mm2)
  • The persistent median artery is present between two nerve divisions - a variant.

The persistent median artery

  • The artery is patent proximal to the carpal tunnel and in the carpal tunnel.
  • Just distal to the carpal tunnel, the artery shows an enlarged echogenic lumen, thick wall. There is no flow in this segment of the artery.

There is no ganglion cyst/mass lesion in the tunnel. There is no flexure tenosynovitis.

Case Discussion

A female presented with palmar region pain for the last few days. There was no history of trauma. She was referred for an ultrasound to check the cause of pain. The ultrasound shows a bifid median nerve which is a variant. There is the presence of a persistent medial artery between the two divisions of the median nerve which is also a variant. These two variants can be present alone or in combination. There is thrombosis of the artery distal to the carpal tunnel in this case. Clinically, the pain of the carpal tunnel syndrome is positional and pain of the thrombosis of an artery is persistent.

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Case information

rID: 71833
Published: 26th Oct 2019
Last edited: 26th Oct 2019
Inclusion in quiz mode: Included

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