Case report

Ultrasound in the diagnosis of a median neuropathy in the forearm: case report

Stuart D Ginn¹ , Michael S Cartwright² , George D Chloros¹ , Francis O Walker² , Joon-Shik Yoon³ , Martin E Brown² and Ethan R Wiesler¹

¹  Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salam, NC, USA

²  Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA

³  Department of Rehabilitation Medicine, Korea University College of Medicine, Seoul, South Korea

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Journal of Brachial Plexus and Peripheral Nerve Injury 2007, 2:23doi:10.1186/1749-7221-2-23

Published:	4 December 2007

Abstract

Background

Electrodiagnostic studies are traditionally used in the diagnosis of focal neuropathies, however they lack anatomical information regarding the nerve and its surrounding structures. The purpose of this case is to show that high-resolution ultrasound used as an adjunct to electrodiagnostic studies may complement this lack of information and give insight to the cause.

Case presentation

A 60-year-old male patient sustained a forearm traction injury resulting in progressive weakness and functional loss in the first three digits of the right hand. High-resolution ultrasound showed the presence of an enlarged nerve and a homogenous soft-tissue structure appearing to engulf the nerve. The contralateral side was normal. Surgery revealed fibrotic bands emanating from the flexor digitorum profundus muscle compressing the median nerve thus confirming the ultrasound findings.

Conclusion

A diagnostically challenging case of median neuropathy in the forearm is presented in which high-resolution ultrasound was valuable in establishing an anatomic etiology and directing appropriate management.