Ultrasound Evaluation of Anatomic Variations of the Median Nerve and Carpal Tunnel

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy and occurs in 3-6% of adults in the United States. While many patients with CTS respond to conservative treatment, there is strong evidence that supports operative management. Post-op complications, while rare, are frequently due to nerve injury and include post-operative pain, dysesthesia, paresthesia, and formation of painful neuromas. Variations in the anatomy of the median nerve increases the risk of damage to branches. Various anatomical variants in the carpal tunnel have been suggested to contribute to median nerve compression, including bifurcation of the median nerve, persistent medial artery, extra tendons within the carpal tunnel, and palmaris longus variations.

The purpose of the study is to utilize ultrasound to investigate the prevalence of variations in the anatomy of the median nerve and surrounding structures, to compare the rate of variation in individuals with carpal tunnel syndrome symptoms verses those without, and to evaluate if specific anatomic variations are more prevalent in different patient populations.