AAEM case report #25: anterior interosseous nerve syndrome

A case study is reported regarding a 57-year-old woman, chose chief complaint was weakness in her thumb that she had noted while gardening. The patient described difficulty pulling weeds out because of an inability to get a firm grip when using the thumb. Physical examination showed weakness of the flexor pollicis longus and flexor digitorum profundus to the index finger. There was no other weakness and no clinical sensory deficit. Electrodiagnostic studies revealed normal median motor and sensory nerve conduction studies with needle examination abnormalities noted only in the flexor pollicis longus, flexor digitorum profundus, and pronator quadratus. The literature on anterior interosseous nerve syndrome (AINS) is reviewed. It is important to differentiate those with idiopathic AINS as part of a neuralgic amyotrophy picture from those with an anatomic cause such as a fibrous band or anomalous muscle. Electrodiagnostic examination can be useful to help make this distinction.