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Fascicular constrictions above elbow typify anterior interosseous nerve syndrome
Darryl B Sneag1, Zsuzsanna Arányi2, Esther M Zusstone3
1Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York.
Introduction:
In this study we tested the hypothesis that fascicular constrictions (FCs) of the median nerve proximal to the elbow joint characterize anterior interosseous nerve syndrome (AINS).
Methods:
Magnetic resonance neurography (MRN) and ultrasound (US) examinations were evaluated in 45 patients with clinically suspected AINS. All 22 patients at site 1 underwent MRN and 8 underwent US; all 23 patients at site 2 underwent US.
Results:
Median nerve FCs were identified in all MRN cases; FCs and/or fascicular enlargements were identified in 88% of US cases. Most FCs were in the mediannerve posterior/posteromedial region and were proximal to the elbow joint line (mean distance: MRN, 5.4 cm; US, 7.5 cm), with the exception of a single FC (located 1 cm distal). No extrinsic compression of median or anterior interosseous nerves was identified in the arm or forearm.
Discussion:
AINS is a noncompressive neuropathy characterized by median nerve FCs in the arm.
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