The Diagnostic Pitfalls in the Pronator Teres Syndrome-A Case Report

Background: Pronator teres syndrome is a rare proximal median neuropathy caused by compression of the median nerve at various points. It is a rare condition, and many times it is mistaken for carpal tunnel syndrome. Methods: There are many authors who refer to the pronator syndrome as a compression of the median nerve at several potential sites of en-trapment in the region of the antecubital fossa, more proximal compression at the Liga-ment of Strutters, and more distally, including lacerus fibrosus within the pronator teres muscle and the anterior interosseous nerve. Results: The diagnostic difficulties in a patient with severe right forearm pain during elbow flexion and pronation are presented. Routine test results, including MRI of the right elbow joint, nerve conduction study of the brachial plexus and ulnar nerve, and electromyographic study of the muscles of the right upper ex-tremity, were normal. Ultrasonography showed an enlarged pronator teres muscle. Conclusions: The patient underwent surgical removal of the lacertus fibrosus. All symptoms resolved.