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
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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