Pronator Syndrome and Other Nerve Compressions That Mimic Carpal Tunnel Syndrome

Lee, Michael J.; LaStayo, Paul C.

doi:10.2519/jospt.2004.34.10.601

Cited by 71 publications

(70 citation statements)

References 30 publications

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“…Carpal tunnel syndrome (CTS) was reported to be caused by a PMA (Jones and Ming, 1988;Proudman and Menz, 1992) or secondary to abnormal pathology of the PMA as calcification (Dickinson and Kleinert, 1991), thromboses (Maxwell et al, 1973;Beran et al, 1997;Khashaba et al, 2002;Kele et al, 2002) atherosclerosis (Luyendijk, 1986), dilatation (Feldkamp et al, 1995;Gassner et al, 2002), and trauma (Tsagarakis et al, 2004). The PMA was also reported to be involved in compression of the MN and anterior interosseous nerve (AIN) in the proximal forearm, resulting in pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS), respectively (Gainor and Jeffrid, 1987;Jones and Ming, 1988;Proudman and Menz, 1992;Lee and LaStayo, 2004). Persistence of the median artery may also occur in conjunction with anomalies of the MN.…”

Section: Introductionmentioning

confidence: 99%

“…Entrapment or compressive neuropathies are widespread clinical problems caused by compression of a nerve when it passes through fibro-osseous or muscular tunnels or deep to aponeurotic and vascular channels such as a persistent median artery (PMA), especially in patients with various occupations or with certain diseases (Spinner et al, 1991;Dellon, 2004;Lee and LaStayo, 2004;Eid and Otsuki, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Persistent median artery: Cadaveric study and review of the literature

et al. 2011

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The persistent median artery (PMA) may compress the median nerve (MN) and may be a significant supply of blood to the hand. Two cases of unilateral PMA (4%) were detected during the dissection of 50 upper limbs. The first case was a 75-year-old, right-handed male who suffered from chronic pain in both upper limbs, especially the left side. A dissection of his left upper limb revealed a PMA piercing both the MN and the medial branch of the anterior interosseous nerve. This artery coursed distally, deep to the transverse carpal ligament (TCL), forming a median-ulnar pattern for the superficial palmar arch (SPA). The PMA was superficial to two nerves at the distal edge of the TCL; the extraligamentous recurrent thenar (RT) branch of the MN and the third common digital nerve (TCDN). The second case was from the left side of an 80-year-old female found to have a high origin of the radial artery with trifurcation of the latter into PMA, common interosseous, and ulnar arteries. The PMA passed deep to the TCL forming a radial-median-ulnar pattern of SPA. Both the transligamentous RT branch of the MN and the TCDN passed deep to the PMA inside the carpal tunnel, before the abnormal crossing of the latter nerve ventral to the SPA on its way to the digits. The relationships of the PMA to various MN branches may have important implications regarding the diagnosis and treatment of MN compressive neuropathies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Persistent median artery: Cadaveric study and review of the literature

et al. 2011

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“…Tinel's test was performed by tapping for three sets of five strikes over the carpal tunnel, as described by Lifchez et al 23 The tests were considered positive if neurological symptoms developed in the median nerve distribution of the hand within one minute. 25 The sensory distribution of the median nerve includes the palm of the hand and the lateral 3½ digits 26 For this study, if symptoms were elicited in at least one of the first three digits or throughout the hand, they were considered positive for median nerve compression. 15 Participants who experienced symptoms of pain, paresthesias, and numbness only in the ulnar nerve distribution of the hand, or digits 4, 5 and the ulnar aspect of the palm, were not considered positive for MNC.…”

Section: Methodsmentioning

confidence: 99%

The Prevalence of Signs of Median Nerve Compression among College Students in Kinesiology

Behee

Wilson

2015

Sport Exerc Med Open J

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Purpose: The purpose of this study was to assess the prevalence of signs of Median Nerve Compression (MNC) among male and female college students. Methods: Forty-one Kinesiology majors, 24 males (58%) and 17 females (42%) completed surveys to assess the volume of physical activity, computer use, and distal upper extremity pain associated with these activities. Each participant was assessed for signs of MNC with the Phalen's test, Tinel's tap test, and the hand elevation test. Grip strength was measured by hand grip dynamometry and participants' percentile norms were calculated. Results: Indications of MNC were present in 17% of participants, (6 males, 1 female). Fiftyone percent of students experienced computer-related hand and forearm musculoskeletal pain. Eighty-one percent of those had pain during extended computer use and 41% of students experienced occasional pain with physical activity. It is noteworthy that 85% of participants used the computer 4 hours per day or less. Also, with each category of computer use and physical activity, 93% of participants had not experienced pain in the last two weeks. Conclusion: Though none of these factors could be associated with MNC, the prevalence of symptoms was similar to carpal tunnel syndrome (14%) in the general population.

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“…The MN can be entrapped in the lower part of the arm at the distal part of the humerus by the ligament of Struthers; proximal elbow by a thickened biceps aponeurosis; elbow joint between the superficial and deep heads of the pronator teres muscle and proximal forearm by a thickened proximal edge of the flexor digitorum superficialis [2,4,11,18]. Adachi (1928) [1] defined the superficial branchial artery (SBA) as the artery that runs superficial to the MN.…”

Section: Introductionmentioning

confidence: 99%