|Title : Case 632|
Age / Sex : 65 / F
Chief complaint : Rt wrist and hand tingling sense for several years
Answer: carpal tunnel syndrome with bifid median nerve
Findings: Two nerve bundles of median nerve in the distal forearm and in the carpal tunnel, to suggest bifid median nerve.
Abrupt caliber change at distal carpal row, to suggest carpal tunnel syndrome.
Differential Diagnosis: None
Discussion: Prevalence of a bifid median nerve is variably reported from 2.8% to 18%. A bifid median nerve may be accompanied by an accessory artery, the persistent median artery of the forearm, which lies in between the two nerve bundles (not definite in this patient).
Association between the bifid median nerve and carpal tunnel syndrome is controversial.
In initial anatomic description by Lanz in 1977, a bifid median nerve was thought to be predisposed to compression in the carpal tunnel because of its relatively higher cross-sectional area compared with a nonbifid median nerve. A recent study of 1026 wrist US with/without carpal tunnel syndrome, however, an association with definite carpal tunnel syndrome was not found
|Total applicants||30||Correct answers||5|
|Total applicants||30||Semi-Correct answers||24|
|윤유성||순천향대 부천병원, 전문의|
|이광진||청주프라임 병원, 전문의|