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Congress: ECR26
Poster Number: C-21560
Type: Poster: EPOS Radiologist (educational)
Authorblock: P. Bhatia1, L. Billone1, J. BABHULKAR2, K. Nathiya3, H. N. Choudur1; 1Hamilton, ON/CA, 2Pune/IN, 3Bhilwara/IN
Disclosures:
Pratibha Bhatia: Nothing to disclose
Lisa Billone: Nothing to disclose
JOBAN BABHULKAR: Nothing to disclose
Kartikeya Nathiya: Nothing to disclose
Hema Nalini Choudur: Nothing to disclose
Keywords: Musculoskeletal system, Neuroradiology peripheral nerve, Ultrasound, Ultrasound-Colour Doppler, Diagnostic procedure, Education and training
Learning objectives -Highlight the relevant anatomy of the median nerve and its potential proximal entrapment sites.-Present illustrative cases with clinical and ultrasound findings demonstrating pathologies of the median nerve or its branches, at sites outside the carpal tunnel.-Emphasize the less common but clinically significant causes of median neuropathy and their impact on patient outcomes.
Read more Background Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment neuropathy, with extensive literature dedicated to its diagnosis and management. However, symptoms in the median nerve distribution may also arise from pathologies of the median nerve or its branches at sites beyond the carpal tunnel.Proximal median nerve compressions can occur independently or in conjunction with carpal tunnel syndrome and are often underrecognized due to their infrequent presentation, overlapping clinical features, and limited description in the literature. Recent studies suggest...
Read more Findings and procedure details ANATOMYCLINICAL ANATOMY AND INNERVATION [fig 1] The median nerve is a mixed motor and sensory nerve of the upper extremity, arising from the medial and lateral cords of the brachial plexus, receiving contributions from the C5-T1 nerve roots. Understanding the nerve course and its innervation is imperative for identifying potential entrapment sites and their clinical implications.Arm: In the arm, the median nerve traverses between the biceps brachii and brachialis adjacent to the brachial artery. There are no major branches from the median nerve...
Read more Conclusion This exhibit underscores the importance of assessing the median nerve beyond the carpal tunnel when evaluating patients with median nerve symptoms. Familiarity with these entities will facilitate a more detailed search to locate the pathology and delineate the etiology, thereby enabling appropriate and timely management.
Read more Personal information Department of Medical Imaging, Hamilton General Hospital, McMaster University
Read more References   Löppönen P, Hulkkonen S, Ryhänen J. Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome. JCM. 2022 July 9;11(14):3988. Meyer P, Lintingre PF, Pesquer L, Poussange N, Silvestre A, Dallaudière B. The Median Nerve at the Carpal Tunnel … and Elsewhere. Journal of the Belgian Society of Radiology. 2018 Jan 31;102(1):17. Nulle K, Jaudzema A. Ultrasonographic evaluation of the median nerve: normal and variant anatomy and appearance. J Ultrason. 2021 Nov 29;21(87):318–25. Shields LBE, Iyer VG, Zhang YP, Shields CB....
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