Analyzing median nerve pathology

Focal neuropathy and flexor tenosynovitis present with similar symptoms but look very different on ultrasound. Learn how to differentiate focal neuropathy, such as carpal tunnel syndrome, from other pathologies.

Mohini Rawat, DPT MS ECS OCS RMSK
Mohini Rawat, DPT MS ECS OCS RMSK
29th Aug 2023 • 1m read
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Analyzing median nerve pathology on ultrasound

Flexor tenosynovitis and ganglion cysts present with symptoms that are similar to those of the focal neuropathy seen in carpal tunnel syndrome. So, when a patient complains of numbness and pain in their wrist, how can you use ultrasound imaging to ensure a correct diagnosis?

Here’s how you can look for evidence of focal neuropathy:

  • Hypoechoic signal in the nerve
  • Cross-section area > 0.09 cm2
  • Hourglass deformity of the nerve

Other conditions can mimic focal neuropathies, such as carpal tunnel syndrome.

Check for evidence of tenosynovitis:

  • Swelling of the flexor tendons
  • Positive color Doppler signs indicating hyperemia

Check for the presence of a ganglion cyst

  • Anechoic cystic mass compressing the median nerve

Watch the full lesson to learn how to identify the carpal tunnel structures on ultrasound and perform an examination of the focal median nerve.

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