[Bifid median nerve in the carpal tunnel: integrated imaging].
OBJECTIVE
Carpal Tunnel Syndrome (CTS) is a neuropathy caused by compression of the median nerve at the level of the wrist, which is caused by different pathologic conditions. In some cases it has been associated with anatomic variations of the median nerve, mainly with the early duplication of the nerve inside the carpal tunnel (III Group of Lanz). The treatment of CTS is mainly surgical consisting in decompression by transection of the transverse carpal ligament, which is better performed by endoscopic release. The aim of our study was to evaluate the possibility to detect this anatomic variant by integrated imaging and assess the value of this information for planning treatment.


METHODS
We report 6 cases of bifid median nerve examined by Ultrasonography (US) using mechanic sectorial and linear array transducers operating at 10 to 13 MHz, and by MR imaging using 0.2 T equipment.


RESULTS
In all cases US transverse scans showed two adjacent oval formations with a structure similar to that of the median nerve. CONCLUSIONS. MR imaging confirmed the sonographic findings in all cases. All patients underwent open surgical treatment by decompression of the median nerve; in all cases an early duplicated median nerve was confirmed.
Iannicelli
E
E
Istituto di Radiologia, II Cattedra, Università La Sapienza, Policlinico Umberto I, Rome, Italy. elsa.iannicelli@mail.uniroma1.it
Almberger
M
M
Chianta
G A
GA
Salvini
V
V
Drudi
F M
FM
Rossi
G
G
Passariello
R
R
D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography