link
Bookmarks
Median Nerve Injury, Elbow
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD, FACR
To access 4,300 diagnoses written by the world's leading experts in radiology.Try it free - 15 days
0
11
0
0

KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Anterior interosseous nerve (AIN) syndrome = Kiloh-Nevin syndrome, pronator syndrome, "honeymooner's paralysis," supracondylar process syndrome, lacertus fibrosus syndrome
            • Definitions

              • Compression/entrapment of median nerve (MN) may cause different symptoms based on level of entrapment
              • AIN syndrome
                • Denervation of flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) muscles of 2nd and 3rd digits
                • Usually pronator quadratus (PQ) muscle involvement
              • Pronator syndrome
                • Pain ± paresthesias in MN distribution
                • Motor nerve involvement is rare
              • Supracondylar process syndrome
                • Rare median neuropathy caused by compression of nerve by ligament of Struthers arising from supracondylar process of humerus

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Schickendantz MS et al: Conditions and injuries affecting the nerves around the elbow. Clin Sports Med. 39(3):597-621, 2020
                                          2. Kincaid JC: Upper extremity neuropathies. Handb Clin Neurol. 161:197-205, 2019
                                          3. Brown JM et al: US of the peripheral nerves of the upper extremity: a landmark approach. Radiographics. 36(2):452-63, 2016
                                          4. De Maeseneer M et al: Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves. Eur J Radiol. 84(4):671-81, 2015
                                          5. Rodner CM et al: Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg. 21(5):268-75, 2013
                                          6. Jacobson JA et al: Entrapment neuropathies I: upper limb (carpal tunnel excluded). Semin Musculoskelet Radiol. 14(5):473-86, 2010
                                          7. Dang AC et al: Unusual compression neuropathies of the forearm, part I: radial nerve. J Hand Surg Am. 34(10):1906-14, 2009
                                          8. Tsai P et al: Median and radial nerve compression about the elbow. Instr Course Lect. 57:177-85, 2008
                                          9. Dunn AJ et al: MR imaging findings of anterior interosseous nerve lesions. Skeletal Radiol. 36(12):1155-62, 2007
                                          10. Kim S et al: Role of magnetic resonance imaging in entrapment and compressive neuropathy--what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity. Eur Radiol. 17(2):509-22, 2007
                                          11. Andreisek G et al: Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 26(5):1267-87, 2006
                                          12. Bordalo-Rodrigues M et al: MR imaging of entrapment neuropathies at the elbow. Magn Reson Imaging Clin N Am. 12(2):247-63, vi, 2004
                                          13. Lee MJ et al: Pronator syndrome and other nerve compressions that mimic carpal tunnel syndrome. J Orthop Sports Phys Ther. 34(10):601-9, 2004
                                          14. Martinoli C et al: Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound. 32(9):438-50, 2004
                                          15. Lubahn JD et al: Uncommon nerve compression syndromes of the upper extremity. J Am Acad Orthop Surg. 6(6):378-86, 1998
                                          16. Dawson DM: Entrapment neuropathies of the upper extremities. N Engl J Med. 329(27):2013-8, 1993
                                          17. Eversmann WW: Proximal median nerve compression. Hand Clin. 8(2):307-15, 1992
                                          18. Werner CO: The anterior interosseous nerve syndrome. Int Orthop. 13(3):193-7, 1989
                                          Related Anatomy
                                          Loading...
                                          Related Differential Diagnoses
                                          Loading...
                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Anterior interosseous nerve (AIN) syndrome = Kiloh-Nevin syndrome, pronator syndrome, "honeymooner's paralysis," supracondylar process syndrome, lacertus fibrosus syndrome
                                                    • Definitions

                                                      • Compression/entrapment of median nerve (MN) may cause different symptoms based on level of entrapment
                                                      • AIN syndrome
                                                        • Denervation of flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) muscles of 2nd and 3rd digits
                                                        • Usually pronator quadratus (PQ) muscle involvement
                                                      • Pronator syndrome
                                                        • Pain ± paresthesias in MN distribution
                                                        • Motor nerve involvement is rare
                                                      • Supracondylar process syndrome
                                                        • Rare median neuropathy caused by compression of nerve by ligament of Struthers arising from supracondylar process of humerus

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Schickendantz MS et al: Conditions and injuries affecting the nerves around the elbow. Clin Sports Med. 39(3):597-621, 2020
                                                                                  2. Kincaid JC: Upper extremity neuropathies. Handb Clin Neurol. 161:197-205, 2019
                                                                                  3. Brown JM et al: US of the peripheral nerves of the upper extremity: a landmark approach. Radiographics. 36(2):452-63, 2016
                                                                                  4. De Maeseneer M et al: Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves. Eur J Radiol. 84(4):671-81, 2015
                                                                                  5. Rodner CM et al: Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg. 21(5):268-75, 2013
                                                                                  6. Jacobson JA et al: Entrapment neuropathies I: upper limb (carpal tunnel excluded). Semin Musculoskelet Radiol. 14(5):473-86, 2010
                                                                                  7. Dang AC et al: Unusual compression neuropathies of the forearm, part I: radial nerve. J Hand Surg Am. 34(10):1906-14, 2009
                                                                                  8. Tsai P et al: Median and radial nerve compression about the elbow. Instr Course Lect. 57:177-85, 2008
                                                                                  9. Dunn AJ et al: MR imaging findings of anterior interosseous nerve lesions. Skeletal Radiol. 36(12):1155-62, 2007
                                                                                  10. Kim S et al: Role of magnetic resonance imaging in entrapment and compressive neuropathy--what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity. Eur Radiol. 17(2):509-22, 2007
                                                                                  11. Andreisek G et al: Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 26(5):1267-87, 2006
                                                                                  12. Bordalo-Rodrigues M et al: MR imaging of entrapment neuropathies at the elbow. Magn Reson Imaging Clin N Am. 12(2):247-63, vi, 2004
                                                                                  13. Lee MJ et al: Pronator syndrome and other nerve compressions that mimic carpal tunnel syndrome. J Orthop Sports Phys Ther. 34(10):601-9, 2004
                                                                                  14. Martinoli C et al: Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound. 32(9):438-50, 2004
                                                                                  15. Lubahn JD et al: Uncommon nerve compression syndromes of the upper extremity. J Am Acad Orthop Surg. 6(6):378-86, 1998
                                                                                  16. Dawson DM: Entrapment neuropathies of the upper extremities. N Engl J Med. 329(27):2013-8, 1993
                                                                                  17. Eversmann WW: Proximal median nerve compression. Hand Clin. 8(2):307-15, 1992
                                                                                  18. Werner CO: The anterior interosseous nerve syndrome. Int Orthop. 13(3):193-7, 1989