Skip to main content

Advertisement

SpringerLink
Log in

Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

This review provides magnetic resonance neurography (MRN) imaging appearances of median neuropathy proximal to the carpal tunnel. Carpal tunnel syndrome (CTS) and its imaging have been extensively described in the literature; however, there is a relative paucity of information on the MR imaging appearances of different pathologies of the median nerve proximal to the carpal tunnel.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. Patijn J, Vallejo R, Janssen M, Huygen F, Lataster A, van Kleef M, et al. Carpal tunnel syndrome. Pain Pract. 2011;11(3):297–301.

    Article  PubMed  Google Scholar 

  2. Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments—a systematic review. Arch Phys Med Rehabil. 2010;91(7):981–1004.

    Article  PubMed  Google Scholar 

  3. Jarvik JG, Comstock BA, Heagerty PJ, Haynor DR, Fulton-Kehoe D, Kliot M, et al. Magnetic resonance imaging compared with electrodiagnostic studies in patients with suspected carpal tunnel syndrome: predicting symptoms, function, and surgical benefit at 1 year. J Neurosurg. 2008;108(3):541–50.

    Article  PubMed  Google Scholar 

  4. Deniz FE, Oksüz E, Sarikaya B, Kurt S, Erkorkmaz U, Ulusoy H, et al. Comparison of the diagnostic utility of electromyography, ultrasonography, computed tomography, magnetic resonance imaging in idiopathic carpal tunnel syndrome determined by clinical findings. Neurosurgery. 2011 Sep 12. [Epub ahead of print].

  5. Chhabra A, Andreisek G, Soldatos T, Wang KC, Flammang AJ, Belzberg AJ, et al. MR neurography: past, present, and future. AJR Am J Roentgenol. 2011;197(3):583–91.

    Article  PubMed  Google Scholar 

  6. Chhabra A, Andreisek G. Chapter 2. Magnetic resonance neurography. 1st ed. Delhi: Jaypee Publishers; 2012. p. 23–35.

    Google Scholar 

  7. Wertsch JJ, Melvin J. Median nerve anatomy and entrapment syndromes: a review. Arch Phys Med Rehabil. 1982;63(12):623–7.

    PubMed  CAS  Google Scholar 

  8. Bayrak IK, Bayrak AO, Kale M, Turker H, Diren B. Bifid median nerve in patients with carpal tunnel syndrome. J Ultrasound Med. 2008;27(8):1129–36.

    PubMed  Google Scholar 

  9. Kabakci NT, Kovanlikaya A, Kovanlikaya I. Tractography of the median nerve. Semin Musculoskelet Radiol. 2009;13(1):18–23. Epub 2009 Feb 23.

    Article  PubMed  Google Scholar 

  10. Rubin DI, Dimberg EL. Martin-Gruber anastomosis and carpal tunnel syndrome: [corrected] morphologic clues to identification. Muscle Nerve. 2010;42(3):457–8.

    Article  PubMed  Google Scholar 

  11. Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects–normal anatomy, variants, and pitfalls. Radiology. 2009;252(1):148–56.

    Article  PubMed  Google Scholar 

  12. Chhabra A, Williams EH, Wang KC, Dellon AL, Carrino JA. MR neurography of neuromas related to nerve injury and entrapment with surgical correlation. AJNR Am J Neuroradiol. 2010;31(8):1363–8. Epub 2010 Feb 4.

    Article  PubMed  CAS  Google Scholar 

  13. Bydder M, Rahal A, Fullerton GD, Bydder GM. The magic angle effect: a source of artifact, determinant of image contrast, and technique for imaging. J Magn Reson Imaging. 2007;25(2):290–300.

    Article  PubMed  Google Scholar 

  14. Filler AG, Maravilla KR, Tsuruda JS. MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature. Neurol Clin. 2004;22(3):643–82. vi-vii.

    Article  PubMed  Google Scholar 

  15. Linda DD, Harish S, Stewart BG, Finlay K, Parasu N, Rebello RP. Multimodality imaging of peripheral neuropathies of the upper limb and brachial plexus. Radiographics. 2010;30(5):1373–400.

    Article  PubMed  Google Scholar 

  16. Chhabra A, Subhawong TK, Williams EH, Wang KC, Hashemi S, Thawait SK, et al. High-resolution MR neurography: evaluation before repeat tarsal tunnel surgery. AJR Am J Roentgenol. 2011;197(1):175–83.

    Article  PubMed  Google Scholar 

  17. Merlini L, Vargas MI, Anooshiravani M, Viallon M, Fluss J, Hanquinet S. Look for the nerves! MR neurography adds essential diagnostic value to routine MRI in pediatric practice: a pictorial overview. J Neuroradiol. 2011;38(3):141–7.

    Article  PubMed  Google Scholar 

  18. Chhabra A, Lee PP, Bizzell C, Soldatos T. 3 Tesla MR neurography-technique, interpretation, and pitfalls. Skeletal Radiol. 2011;40(10):1249–60. Epub 2011 May 6.

    Article  PubMed  Google Scholar 

  19. Chhabra A, Soldatos T, Subhawong TK, Machado AJ, Thawait SK, Wang KC, et al. The application of three-dimensional diffusion-weighted PSIF technique in peripheral nerve imaging of the distal extremities. J Magn Reson Imaging. 2011;34(4):962–7.

    Article  PubMed  Google Scholar 

  20. Tagliafico AS, Bäumer P, Bendszus M, Pham M. Ulnar neuropathy at the elbow: is MR imaging reliable? Radiology. 2011;261(2):659–60.

    Article  PubMed  Google Scholar 

  21. Tsai P, Steinberg DR. Median and radial nerve compression about the elbow. J Bone Joint Surg Am. 2008;90(2):420–8.

    PubMed  Google Scholar 

  22. Staff NP, Engelstad J, Klein CJ, Amrami KK, Spinner RJ, Dyck PJ, et al. Post-surgical inflammatory neuropathy. Brain. 2010;133(10):2866–80. Epub 2010 Sep 15.

    Article  PubMed  Google Scholar 

  23. Zhang J, Moore AE, Stringer MD. Iatrogenic upper limb nerve injuries: a systematic review. ANZ J Surg. 2011;81(4):227–36.

    Article  PubMed  Google Scholar 

  24. Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D. Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics. 2006;26(5):1267–87.

    Article  PubMed  Google Scholar 

  25. Seddon HJ. Peripheral nerve injuries in Great Britain during World War II; a review. Arch Neurol Psychiatry. 1950;63(1):171–3.

    PubMed  CAS  Google Scholar 

  26. Beekman R, van den Berg LH, Franssen H, Visser LH, van Asseldonk JT, Wokke JH. Ultrasonography shows extensive nerve enlargements in multifocal motor neuropathy. Neurology. 2005;65(2):305–7.

    Article  PubMed  CAS  Google Scholar 

  27. Adachi Y, Sato N, Okamoto T, Sasaki M, Komaki H, Yamashita F, et al. Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient. Neuroradiology. 2011;53(1):3–11.

    Article  PubMed  Google Scholar 

  28. Thawait SK, Chaudhry V, Thawait GK, Wang KC, Belzberg A, Carrino JA, et al. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol. 2011;32(8):1365–72.

    Article  PubMed  CAS  Google Scholar 

  29. Blyton F, Ryan MM, Ouvrier RA, Burns J. Muscle cramp in pediatric Charcot–Marie–Tooth disease type 1A: prevalence and predictors. Neurology. 2011;77(24):2115–8.

    Article  PubMed  Google Scholar 

  30. Jani-Acsadi A, Krajewski K, Shy ME. Charcot–Marie–Tooth neuropathies: diagnosis and management. Semin Neurol. 2008;28(2):185–94.

    Article  PubMed  Google Scholar 

  31. Swarnkar A, Fukui MB, Fink DJ, Rao GR. MR imaging of brachial plexopathy in neurolymphomatosis. AJR Am J Roentgenol. 1997;169(4):1189–90.

    PubMed  CAS  Google Scholar 

  32. Kumar B, Pradhan A. Fine needle aspiration cytology in diagnosis of pure neuritic leprosy. Patholog Res Int. 2011;2011:158712.

    PubMed  Google Scholar 

  33. Battaglia TC, Pannunzio ME, Chhabra AB. A carpometacarpal joint ganglion cyst causing median neuropathy. Am J Orthop (Belle Mead NJ). 2006;35(4):186–8.

    Google Scholar 

  34. Walter B, Ebert S, Sproedt J, Jandali AR. Intraneural lipoma of the median nerve. Handchir Mikrochir Plast Chir. 2011;43(5):317–8.

    Article  PubMed  CAS  Google Scholar 

  35. Verma R, Chhabra A, Bhutani C, Jain D, Singh J. Neurofibromatosis: a diagnostic mimicker on CT in a known case of malignancy. Indian J Cancer. 2002;39(4):151–3.

    PubMed  CAS  Google Scholar 

  36. Jain TP, Srivastava DN, Mittal R, Gamanagatti S. Fibrolipomatous hamartoma of median nerve. Australas Radiol. 2007 Oct;51 Spec No.:B98-B100.

  37. Chiang CL, Tsai MY, Chen CK. MRI diagnosis of fibrolipomatous hamartoma of the median nerve and associated macrodystrophia lipomatosa. J Chin Med Assoc. 2010;73(9):499–502.

    Article  PubMed  Google Scholar 

  38. Lacour-Petit MC, Lozeron P, Ducreux D. MRI of peripheral nerve lesions of the lower limbs. Neuroradiology. 2003;45(3):166–70.

    PubMed  CAS  Google Scholar 

  39. Purkait R, Samanta T, Thakur S, Dhar S. Neurocutaneous syndrome: a prospective study. Indian J Dermatol. 2011;56(4):375–9.

    Article  PubMed  Google Scholar 

  40. Chhabra A, Blakely J. Whole-body imaging in schwannomatosis. Neurology. 2011;76(23):2035.

    Article  PubMed  Google Scholar 

  41. Cai W, Kassarjian A, Bredella MA, Harris GJ, Yoshida H, Mautner VF, et al. Tumor burden in patients with neurofibromatosis types 1 and 2 and schwannomatosis: determination on whole-body MR images. Radiology. 2009;250(3):665–73.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Avneesh Chhabra acknowledges the support of research grants from Siemens AG and Integra Life Sciences as well as the support of a GE-AUR Fellowship. John A. Carrino acknowledges a grant from Siemens Medical Systems to study MR neurography.

Conflict of interest

The authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD, 21287, USA

    Gaurav K. Thawait, Ty K. Subhawong, John Eng, John A. Carrino & Avneesh Chhabra

  2. Department of Radiology, Yale University, Bridgeport Hospital, Bridgeport, CT, USA

    Shrey K. Thawait

  3. Department of Radiology, University Hospital Zurich, Zurich, Switzerland

    Gustav Andreisek

  4. Department of Neurosurgery, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD, 21287, USA

    Alan J. Belzberg

  5. Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, 601 North Caroline Street, Room 4240, Baltimore, MD, 21287, USA

    Gaurav K. Thawait

Authors
  1. Gaurav K. Thawait
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ty K. Subhawong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shrey K. Thawait
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gustav Andreisek
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alan J. Belzberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. John Eng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. John A. Carrino
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Avneesh Chhabra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Avneesh Chhabra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thawait, G.K., Subhawong, T.K., Thawait, S.K. et al. Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel. Skeletal Radiol 41, 623–632 (2012). https://doi.org/10.1007/s00256-012-1380-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1380-y

Keywords

Search

Navigation