Thrombosis of persistent median artery of upper limb

Case contributed by Dr Maulik S Patel

Presentation

Pain along mid line wrist - distal forearm - palmer aspect - 10 days. No trauma. Works on a desk top every day.

Patient Data

Age: about 30 - 35 yrs
Gender: Male
Modality: Ultrasound

There is bifurcation of median nerve before distal radio-ulnar joint. It is a normal variant.

Combined Cross sectional area of two branches -   9 mm
Ulnar division - 1 mm
Radial division - 8 mm
( Normal - up to 11 mm )

Persistent median artery is noted flanked by veins on both sides.
Artery shows echogenic wall, non-compressible lumen at wrist and proximal palm.
No flow is noted in this segment.
Both veins are compressible.

No mass lesion is seen. No tenosynovitis is seen.

Case Discussion

Findings of bifid median nerve along with a persistent median artery - normal variant.

There seems to be repeated microtrauma to wrist - volar aspect due to long hrs work on a desk top.

Effect of this is seen as thrombosis of artery in the region.

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Case Information

rID: 30799
Case created: 4th Sep 2014
Last edited: 22nd Jul 2016
Inclusion in quiz mode: Included

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