Stavros Kara, Paik David, Motiwala Rajeev, Weinberger Jesse, Zhou Lan, Shin Susan
Department of Neurology, Warren Alpert Medical School of Brown University, Providence, Rhode island, USA.
Department of Radiology, Morristown Medical Center, Morristown, New Jersey, USA.
Muscle Nerve. 2016 Mar;53(3):485-7. doi: 10.1002/mus.24974. Epub 2015 Dec 29.
Carpal tunnel syndrome (CTS) is a common clinical syndrome seen in the outpatient setting that is easily confirmed by electrodiagnostic testing.
We describe the case of a patient who presented with the classic symptoms and neurological examination for CTS, but had a normal nerve conduction study and electromyogram.
Neuromuscular ultrasound of the median nerve on the symptomatic side revealed penetration of the nerve by a persistent median artery and vein in the mid-forearm, with a positive sonographic Tinel sign over this spot. This finding is an anatomical variation that has been described sparingly in the literature, mostly in cadavers. It has not been reported previously to be a mimic of CTS.
This case demonstrates the diagnostic utility of neuromuscular ultrasound and the importance of considering an anatomical variation involving the median nerve in the differential diagnosis of CTS.
腕管综合征（CTS）是门诊常见的临床综合征，通过电诊断测试很容易确诊。
我们描述了一例患者，该患者表现出CTS的典型症状和神经学检查结果，但神经传导研究和肌电图正常。
患侧正中神经的神经肌肉超声显示，在前臂中部有一条持续存在的正中动静脉穿过神经，该部位超声Tinel征阳性。这一发现是一种解剖变异，在文献中鲜有描述，大多是在尸体上。此前尚未报道其可模拟CTS。
本病例证明了神经肌肉超声的诊断效用，以及在CTS鉴别诊断中考虑正中神经解剖变异的重要性。
