Department of Radiology, NYU Langone Health, Langone Orthopedic Center, 333 E 38th St, 6th Floor, New York, NY, 10016, USA.
Division of Hand Surgery, Department of Orthopedic Surgery; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, 530 1st Avenue, Suite 8U, New York, NY, 10016, USA.
Skeletal Radiol. 2024 Mar;53(3):577-582. doi: 10.1007/s00256-023-04410-8. Epub 2023 Aug 11.
Pronator syndrome is a median nerve entrapment neuropathy that can be difficult to diagnose due to its variable presentation and objective findings. Neurolymphomatosis is an uncommon disease in which malignant lymphocytes infiltrate central or peripheral nerve endoneurium and is often missed for prolonged periods prior to diagnosis. We present a rare case of pronator syndrome and anterior interosseous nerve palsy due to neurolymphomatosis that was occult on initial MRI in spite of the presence of a median nerve mass discovered intra-operatively during neurolysis. This case demonstrates the value of ultrasound for the examination of peripheral nerve pathology and illustrates its utility as an adjunct to MRI, in part due to the ability to screen a large region.
正中神经卡压性神经病,即旋前肌综合征,因其表现和客观发现具有多变性,故诊断较为困难。神经淋巴瘤病是一种罕见疾病,其中恶性淋巴细胞浸润中枢或周围神经内膜,在诊断之前往往会被长期忽视。我们报告了一例罕见的由于神经淋巴瘤病引起的旋前肌综合征和骨间前神经麻痹的病例,尽管在神经松解术中发现了正中神经肿块,但最初的 MRI 检查并未发现该病变。该病例表明,超声检查对外周神经病变具有重要价值,并展示了其作为 MRI 的辅助手段的实用性,这在一定程度上要归因于其能够对较大区域进行筛查。