Thrombosis of persistent median artery of upper limb

Case contributed by Dr Maulik S Patel

Presentation

Non-traumatic wrist pain - 7 - 10 days. Pain along mid line of distal forearm - wrist on volar side. No movement restriction / finger tingling. Once started; pain never disappeared.

Patient Data

Age: about 45 yrs
Gender: Male

Median nerve was tracted from distal forearm to palm.

There is early division of nerve before wrist - bifid nerve  -- a variant.

Persistant median artery is noted flanked by veins  -- a variant.

 

Persistant median artery

- echogenic lumen without flow in distal forearm and wrist and proximal palm.

- Artery is patent in mid forearm.

- Flow is noted in proximal palm after bifercation due to retrograde filling.

 

Vein on sides of Persistant median artery

- compressible.

 

Maximum Cross sectional area of nerve just proximal to tunnel      

- Radial division                       -  5 mm2                 

- Ulnar division                        -   2 mm2                

- Combined                              -  7 mm2                 ( Normal - upto 11 mm2 )

 

No  Ganglion cyst / Flexure tenosynotis is noted.

Case Discussion

Findings of thrombosis of persistant median artery.

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Case information

rID: 38072
Case created: 3rd Jul 2015
Last edited: 3rd Oct 2015
Inclusion in quiz mode: Excluded

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