Median nerve penetration by a persistent median artery and vein mimicking carpal tunnel syndrome

Kara Stavros, David Paik, Rajeev Motiwala, Jesse Weinberger, Lan Zhou, Susan Shin

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Introduction: Carpal tunnel syndrome (CTS) is a common clinical syndrome seen in the outpatient setting that is easily confirmed by electrodiagnostic testing. Methods: We describe the case of a patient who presented with the classic symptoms and neurological examination for CTS, but had a normal nerve conduction study and electromyogram. Results: Neuromuscular ultrasound of the median nerve on the symptomatic side revealed penetration of the nerve by a persistent median artery and vein in the mid-forearm, with a positive sonographic Tinel sign over this spot. This finding is an anatomical variation that has been described sparingly in the literature, mostly in cadavers. It has not been reported previously to be a mimic of CTS. Conclusions: This case demonstrates the diagnostic utility of neuromuscular ultrasound and the importance of considering an anatomical variation involving the median nerve in the differential diagnosis of CTS. Muscle Nerve 53: 485-487, 2016

Original languageEnglish (US)
Pages (from-to)485-487
Number of pages3
JournalMuscle and Nerve
Issue number3
StatePublished - Mar 1 2016


  • Carpal tunnel syndrome
  • Median nerve penetration
  • Median neuropathy
  • Neuromuscular ultrasound
  • Persistent median artery

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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