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12.12.2016 | Ultrasound | Ausgabe 7/2017 Open Access

European Radiology 7/2017

High-resolution ultrasound visualization of the recurrent motor branch of the median nerve: normal and first pathological findings

Zeitschrift:
European Radiology > Ausgabe 7/2017
Autoren:
Georg Riegler, Christopher Pivec, Hannes Platzgummer, Doris Lieba-Samal, Peter Brugger, Suren Jengojan, Martin Vierhapper, Gerd Bodner
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00330-016-4671-1) contains supplementary material, which is available to authorized users.

Abstract

Purpose

To evaluate in a prospective study the possibility of visualization and diagnostic assessment of the recurrent motor branch (RMB) of the median nerve with high-resolution ultrasound (HRUS).

Materials and methods

HRUS with high-frequency probes (18–22 MhZ) was used to locate the RMB in eight fresh cadaveric hands. To verify correct identification, ink-marking and consecutive dissection were performed. Measurement of the RMB maximum transverse-diameter, an evaluation of the origin from the median nerve and its course in relation to the transverse carpal ligament, was performed in both hands of ten healthy volunteers (n = 20). Cases referred for HRUS examinations for suspected RMB lesions were also assessed.

Results

The RMB was clearly visible in all anatomical specimens and all volunteers. Dissection confirmed HRUS findings in all anatomical specimens. Mean RMB diameter in volunteers was 0.7 mm ± 0.1 (range, 0.6–1). The RMB originated from the radial aspect in 11 (55%), central aspect in eight (40%) and ulnar aspect in one (5%) hand. Nineteen (95%) extraligamentous courses and one (5%) subligamentous course were detected. Three patients with visible RMB abnormalities on HRUS were identified.

Conclusion

HRUS is able to reliably visualize the RMB, its variations and pathologies.

Key Points

Ultrasound allows visualization of the recurrent motor branch of the median nerve.
Ultrasound may help clinicians to assess patients with recurrent motor branch pathologies.
Patient management may become more appropriate and targeted therapy could be improved.

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Zusatzmaterial
Movie Anatomical variant. Video sequence of sonographic findings in a volunteer with a recurrent motor branch originating from the ulnar aspect of the median nerve, crossing the anterior aspect of the median and coursing beneath the TCL (subligamentous) toward the thenar musculature (MP4 40229 kb)
330_2016_4671_MOESM1_ESM.mp4
Literatur
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