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Median Nerve Injury
Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD
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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
            • Definitions

              • AIN syndrome
                • Denervation of flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) muscles of 2nd and 3rd digits
                • ± pronator quadratus muscle involvement
                • Also called Kiloh-Nevin syndrome
              • Pronator syndrome
                • Pain ± paresthesias in median nerve 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

                    • 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. Rodner CM et al: Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg. 21(5):268-75, 2013
                                        2. Dang AC et al: Unusual compression neuropathies of the forearm, part I: radial nerve. J Hand Surg Am. 34(10):1906-14, 2009
                                        3. Tsai P et al: Median and radial nerve compression about the elbow. Instr Course Lect. 57:177-85, 2008
                                        4. Dunn AJ et al: MR imaging findings of anterior interosseous nerve lesions. Skeletal Radiol. 36(12):1155-62, 2007
                                        5. 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
                                        6. Andreisek G et al: Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 26(5):1267-87, 2006
                                        7. 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
                                        8. 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
                                        9. Martinoli C et al: Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound. 32(9):438-50, 2004
                                        10. Lubahn JD et al: Uncommon nerve compression syndromes of the upper extremity. J Am Acad Orthop Surg. 6(6):378-86, 1998
                                        11. Dawson DM: Entrapment neuropathies of the upper extremities. N Engl J Med. 329(27):2013-8, 1993
                                        12. Eversmann WW: Proximal median nerve compression. Hand Clin. 8(2):307-15, 1992
                                        13. Werner CO: The anterior interosseous nerve syndrome. Int Orthop. 13(3):193-7, 1989
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        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
                                                  • Definitions

                                                    • AIN syndrome
                                                      • Denervation of flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) muscles of 2nd and 3rd digits
                                                      • ± pronator quadratus muscle involvement
                                                      • Also called Kiloh-Nevin syndrome
                                                    • Pronator syndrome
                                                      • Pain ± paresthesias in median nerve 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

                                                          • 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. Rodner CM et al: Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg. 21(5):268-75, 2013
                                                                              2. Dang AC et al: Unusual compression neuropathies of the forearm, part I: radial nerve. J Hand Surg Am. 34(10):1906-14, 2009
                                                                              3. Tsai P et al: Median and radial nerve compression about the elbow. Instr Course Lect. 57:177-85, 2008
                                                                              4. Dunn AJ et al: MR imaging findings of anterior interosseous nerve lesions. Skeletal Radiol. 36(12):1155-62, 2007
                                                                              5. 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
                                                                              6. Andreisek G et al: Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 26(5):1267-87, 2006
                                                                              7. 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
                                                                              8. 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
                                                                              9. Martinoli C et al: Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound. 32(9):438-50, 2004
                                                                              10. Lubahn JD et al: Uncommon nerve compression syndromes of the upper extremity. J Am Acad Orthop Surg. 6(6):378-86, 1998
                                                                              11. Dawson DM: Entrapment neuropathies of the upper extremities. N Engl J Med. 329(27):2013-8, 1993
                                                                              12. Eversmann WW: Proximal median nerve compression. Hand Clin. 8(2):307-15, 1992
                                                                              13. Werner CO: The anterior interosseous nerve syndrome. Int Orthop. 13(3):193-7, 1989