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There is the bifurcation of the median nerve proximal to the carpal tunnel. It is a normal variant and known as a bifid median nerve. There is no associated persistent median artery.
Combined Cross-sectional area of two branches - normal combined up to 11 mm2
Proximal to tunnel - ulnar division - 3 mm2 + radial division - 3 mm2 - Total 6 mm2
Distal to tunnel - ulnar division - 8 mm2 + radial division - 6 mm2 - Total 14 mm2
Edema followed by tapering distally to the carpal tunnel involves both ulnar and radial divisions which is known as an inverted notch sign.
No intratunnel mass lesion/ flexor tenosynovitis.