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Nerve Entrapment Syndromes, Wrist
Kambiz Motamedi, MD, FACR; Carol L. Andrews, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Carpal tunnel syndrome (CTS): median neuropathy
            • Ulnar tunnel syndrome: ulnar neuropathy, Guyon canal syndrome, cyclist's palsy
            • Wartenberg syndrome: cheiralgia paresthetica
            • Flexor retinaculum: transverse carpal ligament
          • Definitions

            • CTS: compression of median nerve at wrist
            • Ulnar tunnel syndrome: compression of ulnar nerve at wrist
            • Wartenberg syndrome: entrapment of superficial (sensory) branch of radial nerve

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Kalia V et al: Imaging of peripheral nerves of the upper extremity. Radiol Clin North Am. 57(5):1063-71, 2019
                                      2. Siegal D et al: Entrapment neuropathies of the upper extremity nerves. Curr Radiol Rep 4:63. 2016
                                      3. Fowler JR et al: A comparison of three diagnostic tests for carpal tunnel syndrome using latent class analysis. J Bone Joint Surg Am. 97(23):1958-61, 2015
                                      4. Chen SH et al: Ulnar tunnel syndrome. J Hand Surg Am. 39(3):571-9, 2014
                                      5. Goitz RJ et al: The transverse carpal ligament: anatomy and clinical implications. J Wrist Surg. 3(4):233-4, 2014
                                      6. Tagliafico A et al: Nerves of the hand beyond the carpal tunnel. Semin Musculoskelet Radiol. 16(2):129-36, 2012
                                      7. Klauser AS et al: Carpal tunnel syndrome assessment with US: value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers. Radiology. 250(1):171-7, 2009
                                      8. Yao L et al: Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel. Skeletal Radiol. 38(4):355-61, 2009
                                      9. Mallouhi A et al: Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography. AJR Am J Roentgenol. 2006 May;186(5):1240-5. Erratum in: AJR Am J Roentgenol. 187(2):266, 2006
                                      10. Wong SM et al: Carpal tunnel syndrome: diagnostic usefulness of sonography. Radiology. 232(1):93-9, 2004
                                      11. Lanzetta M et al: Entrapment of the superficial branch of the radial nerve (Wartenberg's syndrome). A report of 52 cases. Int Orthop. 17(6):342-5, 1993
                                      12. Mesgarzadeh M et al: Carpal tunnel: MR imaging. Part I. Normal anatomy. Radiology. 171(3):743-8, 1989
                                      13. Mesgarzadeh M et al: Carpal tunnel: MR imaging. Part II. Carpal tunnel syndrome. Radiology. 171(3):749-54, 1989
                                      14. Baird DB et al: Delayed ulnar-nerve palsy following a fracture of the hamate. J Bone Joint Surg Am. 50(3):570-2, 1968
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Carpal tunnel syndrome (CTS): median neuropathy
                                                • Ulnar tunnel syndrome: ulnar neuropathy, Guyon canal syndrome, cyclist's palsy
                                                • Wartenberg syndrome: cheiralgia paresthetica
                                                • Flexor retinaculum: transverse carpal ligament
                                              • Definitions

                                                • CTS: compression of median nerve at wrist
                                                • Ulnar tunnel syndrome: compression of ulnar nerve at wrist
                                                • Wartenberg syndrome: entrapment of superficial (sensory) branch of radial nerve

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Imaging Recommendations

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Kalia V et al: Imaging of peripheral nerves of the upper extremity. Radiol Clin North Am. 57(5):1063-71, 2019
                                                                          2. Siegal D et al: Entrapment neuropathies of the upper extremity nerves. Curr Radiol Rep 4:63. 2016
                                                                          3. Fowler JR et al: A comparison of three diagnostic tests for carpal tunnel syndrome using latent class analysis. J Bone Joint Surg Am. 97(23):1958-61, 2015
                                                                          4. Chen SH et al: Ulnar tunnel syndrome. J Hand Surg Am. 39(3):571-9, 2014
                                                                          5. Goitz RJ et al: The transverse carpal ligament: anatomy and clinical implications. J Wrist Surg. 3(4):233-4, 2014
                                                                          6. Tagliafico A et al: Nerves of the hand beyond the carpal tunnel. Semin Musculoskelet Radiol. 16(2):129-36, 2012
                                                                          7. Klauser AS et al: Carpal tunnel syndrome assessment with US: value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers. Radiology. 250(1):171-7, 2009
                                                                          8. Yao L et al: Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel. Skeletal Radiol. 38(4):355-61, 2009
                                                                          9. Mallouhi A et al: Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography. AJR Am J Roentgenol. 2006 May;186(5):1240-5. Erratum in: AJR Am J Roentgenol. 187(2):266, 2006
                                                                          10. Wong SM et al: Carpal tunnel syndrome: diagnostic usefulness of sonography. Radiology. 232(1):93-9, 2004
                                                                          11. Lanzetta M et al: Entrapment of the superficial branch of the radial nerve (Wartenberg's syndrome). A report of 52 cases. Int Orthop. 17(6):342-5, 1993
                                                                          12. Mesgarzadeh M et al: Carpal tunnel: MR imaging. Part I. Normal anatomy. Radiology. 171(3):743-8, 1989
                                                                          13. Mesgarzadeh M et al: Carpal tunnel: MR imaging. Part II. Carpal tunnel syndrome. Radiology. 171(3):749-54, 1989
                                                                          14. Baird DB et al: Delayed ulnar-nerve palsy following a fracture of the hamate. J Bone Joint Surg Am. 50(3):570-2, 1968