Superficial arm arteries revisited: Brother and sister with absent radial pulse

Atypical or superficial courses of arteries of the arm may cause accidents in therapeutic and surgical procedures. Magnetic resonance imaging (MRI) was performed in a female patient and her brother. In addition, 109 cadaver arms were evaluated for superficial arm arteries and relevant vessels were measured with a calliper. In the patient and her brother the distal radial artery was absent in the normal position. Magnetic resonance imaging showed an artery surrounding the distal radius that nourished the dorsal and palmar hand. In addition, a strongly developed median artery was expressed in the patient's brother. It is noteworthy that the female patient suffered from occasional hand pain while her brother did not, which is likely due to the additional expression of a median artery. A high origin of radial artery is found 3.67% of the examined cadavers and can be followed by additional vessels nourishing the biceps brachii or by connections to the brachial artery in the cubital fossa. Superficial ulnar arteries were detected in 1.83% of the cadavers, in both instances accompanied by an absent palmaris longus. Additionally, in one case the fork of the median nerve has moved distally and took its lateral fork from musculocutaneous nerve. In conclusion, family members can bear identical arterial variations as has been observed in the patient's brother. High origin of radial artery and superficial ulnar artery can be accompanied by additional variations concerning vessels, muscles or nerves which have to be considered in the context of invasive and surgical procedures.