RESUMO
OBJECTIVE: Imaging of a bifid median nerve has not been previously described in the radiology literature. We present three cases of bifid median nerve. The first is a patient with carpal tunnel syndrome seen on sonography and confirmed at surgery. The other two were found among 10 cadaveric specimens and were imaged with sonography and MR imaging. Confirmation of bifid median nerve in these two specimens was obtained using anatomic and histologic correlation. CONCLUSION: Sonography and MR imaging can allow effective diagnosis and delineation of a bifid median nerve in the wrist. This diagnosis is important to make before carpal tunnel release or other wrist surgeries are performed to avoid nerve injury. Furthermore, the sonographic size criteria for diagnosing carpal tunnel syndrome in nonbifid median nerves may not be accurate in evaluating bifid median nerves.
Assuntos
Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/diagnóstico , Imageamento por Ressonância Magnética , Nervo Mediano/anormalidades , Adolescente , Cadáver , Feminino , Humanos , Ultrassonografia , PunhoRESUMO
This article presents a new technique for diagnosing carpal tunnel syndrome using ultrasound. The ultrasound characteristics of the normal and abnormal median nerve are discussed in relation to carpal tunnel syndrome. The development of ultrasound as a new diagnostic modality for carpal tunnel syndrome is presented in a three-part study correlating the ultrasound measurements of the median nerve and electromyogram of the median nerve. A new algorithm for evaluating patients with carpal tunnel syndrome is presented.
Assuntos
Síndrome do Túnel Carpal/diagnóstico , Eletromiografia , Nervo Mediano/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Análise de Variância , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/patologia , Síndrome do Túnel Carpal/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Nervo Mediano/patologia , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , UltrassonografiaRESUMO
Absence of the right pectoralis major muscle and hypoplasia of the ipsilateral breast was observed in 3 females and hypoplasia or agenesis of the right pectoralis major muscle in 2 males of the same family. One member of this family, a 17-year-old girl, underwent a right latissimus dorsi muscle flap, placement of silicone-gel breast implant, and a right infraclavicular natural Y prosthesis. Although none of our 5 patients from this family had congenital upper limb abnormalities, we believe that they still qualify as having Poland's syndrome. This would distinguish them as being the fourteenth known family reported in the world literature with this diagnosis. A brief review of the history as well as hypotheses of etiological mechanisms are presented.
