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Carpal tunnel: MR imaging. Part I. Normal anatomy
M Mesgarzadeh1, C D Schneck, A Bonakdarpour
1Department of Diagnostic Imaging, Temple University Hospital and School of Medicine, Philadelphia, PA 19140.
Radiology
|June 1, 1989
Summary
Magnetic resonance (MR) imaging accurately visualizes carpal tunnel anatomy, correlating well with gross specimens. This study details key structures like the median nerve and ligaments for improved understanding of wrist anatomy.
Area of Science:
- Orthopedics
- Radiology
- Anatomy
Background:
- The carpal tunnel and Guyon canal contain critical neurovascular structures.
- Accurate anatomical depiction is essential for diagnosing carpal tunnel syndrome and related pathologies.
Purpose of the Study:
- To correlate magnetic resonance (MR) imaging findings of the carpal tunnel with gross anatomical structures.
- To establish the utility of MR imaging in delineating normal wrist anatomy.
Main Methods:
- MR imaging of 20 healthy volunteers' wrists and nine cadaveric specimens.
- Sectioning of cadaveric specimens in imaging planes and dissection of three additional specimens.
- Direct correlation between imaged morphology and gross anatomy.
Main Results:
- Axial MR images clearly showed the carpal tunnel's bony and ligamentous walls.
- The median nerve was well-defined, with surrounding fat noted in some cases.
- Coronal images optimally visualized the triangular fibrocartilage and collateral ligaments.
- The median nerve showed flattening at the pisiform bone level, without significant size increase.
- The flexor retinaculum exhibited potential for slight palmar bowing.
Conclusions:
- MR imaging is a valuable tool for demonstrating normal carpal tunnel anatomy.
- Detailed anatomical correlation aids in interpreting MR images of the wrist.
- Understanding normal variations in median nerve and flexor retinaculum morphology is crucial.