Presentation
Previous traumatic median nerve injury and surgical repair. Now thumb pain.
Patient Data
Proximal to the carpal tunnel there is a hypoechoic avascular mass continuous with the median nerve.
Bifid median nerve. Arising from the radial/lateral portion, there is a very high T2 signal nodule with vivid post-contrast enhancement just proximal to the carpal tunnel inlet at the level of the pisiform. Linear low T1 signal in the overlying subcutaneous soft tissues reflective of scarring. Mild edema of the thenar eminence musculature.
Case Discussion
This patient presented a few years after surgical repair to a traumatic median nerve injury, which is the typical timeframe for a traumatic neuroma to develop. The imaging findings are typical, although the presence of a bifid median nerve is uncommon it is is not unusual.