Traumatic median neuropathy with subacute denervation

Case contributed by Utkarsh Kabra


Trauma to hand, difficulty in flexion of thumb and fingers.

Patient Data

Age: 30 years
Gender: Male

Edema and hyperintensity involving median nerve starting at the level of the base of second/third metacarpals, involving a length of approx 19 mm. Overall continuity of median nerve appears maintained.

Patchy edema is seen involving pronator quadratus muscle, muscles of thenar eminence, and first and second lumbricals.

Lobulated cystic lesion measuring approx 12 x 5 mm is seen at volar aspect of trapezoid, just indenting flexor pollicis longus tendon.

Case Discussion

Edema and hyperintensity involving the median nerve suggest post-traumatic neural edema. Patchy edema involving pronator quadratus muscle, muscles of the thenar eminence, and the first and second lumbricals (distribution of median nerve) suggesting subacute denervation edema.

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