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Carpal tunnel syndrome

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Clinical diagnosis of Bilateral carpal tunnel syndrome. B/L NCV positive for CTS (right > left).

Patient Data

Age: 45
Gender: Female
ultrasound

Right - Maximum cross sectional area of nerve just proximal to tunnel - 19 mm2

Left median nerve is bifid. Radial division is larger than ulnar.

Left  - Bifid nerve - Maximum combined cross sectional area of nerve just proximal to tunnel - 11 mm2

No mass lesion / tenosynovitis on either side.

Case Discussion

10 mm2 is commonly considered upper normal limit for non-bifid median nerve cross sectional area.

11 mm2 is commonly considered upper normal limit for bifid median nerve cross sectional area.

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