Anterior interosseous neuropathy: Difference between revisions
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==Background== | ==Background== | ||
*Anterior interosseous nerve (C5-T1) is a branch of the median nerve that supplies motor innervation to the deep forearm muscles | [[File:Nerves of the left upper extremity.gif|thumb|Nerves of the left upper extremity with anterior interosseous (volar interosseus) labeled at center right.]] | ||
*Anterior interosseous nerve (C5-T1), also known as the volar interosseous nerve, is a branch of the median nerve that supplies motor innervation to the deep forearm muscles | |||
*Compression or injury can cause an isolated AIN palsy | *Compression or injury can cause an isolated AIN palsy | ||
*[[Brachial plexopathy]] or cervical spine pathologies may present with combined median nerve palsies | *[[Brachial plexopathy]] or cervical spine pathologies may present with combined median nerve palsies | ||
== | ===Causes=== | ||
*[[Peripheral neuropathy]] | |||
*Peripheral neuropathy | |||
**Entrapment between forearm muscles or tendons | **Entrapment between forearm muscles or tendons | ||
**FPL tendon rupture (usually with severe rheumatic disease) | **FPL tendon rupture (usually with severe rheumatic disease) | ||
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*Iatrogenic | *Iatrogenic | ||
=== | ==Clinical Features== | ||
*May have forearm pain although not as common in other median nerve compression syndromes<ref>Dang AC et al. Unusual Compression Neuropathies of the Forearm, Part 2: Median Nerve. JHS. 2009;34A:1915-1920.</ref> | |||
* | *Weakness of finger flexion (FDL), thumb flexion (FPL), and pronation (pronator quadratus) | ||
*Inability to hold a piece of paper between index and thumb fingertips (can't make "OK" sign) | |||
* | *No sensory loss | ||
* | |||
==Differential Diagnosis== | |||
{{Upper extremity peripheral nerve syndromes}} | |||
==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis | *Clinical diagnosis | ||
*Plain films | *Plain films | ||
*Outpatient | *Outpatient EMG or [[MRI]] | ||
==Management== | ==Management== | ||
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==See Also== | ==See Also== | ||
*[[Peripheral nerve syndromes]] | |||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Neurology]] | |||
Latest revision as of 18:13, 3 November 2021
Background
- Anterior interosseous nerve (C5-T1), also known as the volar interosseous nerve, is a branch of the median nerve that supplies motor innervation to the deep forearm muscles
- Compression or injury can cause an isolated AIN palsy
- Brachial plexopathy or cervical spine pathologies may present with combined median nerve palsies
Causes
- Peripheral neuropathy
- Entrapment between forearm muscles or tendons
- FPL tendon rupture (usually with severe rheumatic disease)
- Trauma
- Forearm fracture
- Pediatric - supracondylar fracture
- Space occupying lesions
- Post-viral neuritis
- Iatrogenic
Clinical Features
- May have forearm pain although not as common in other median nerve compression syndromes[1]
- Weakness of finger flexion (FDL), thumb flexion (FPL), and pronation (pronator quadratus)
- Inability to hold a piece of paper between index and thumb fingertips (can't make "OK" sign)
- No sensory loss
Differential Diagnosis
Upper extremity peripheral nerve syndromes
Median Nerve Syndromes
Ulnar Nerve Syndromes
Radial Nerve Syndromes
- Radial neuropathy at the spiral groove (ie. "Saturday night palsy")
- Posterior interosseous neuropathy
Proximal Neuropathies
- Suprascapular neuropathy
- Long thoracic neuropathy
- Axillary neuropathy
- Spinal accessory neuropathy
- Musculocutaneous neuropathy
Other
Evaluation
- Clinical diagnosis
- Plain films
- Outpatient EMG or MRI
Management
- Nonoperative: rest, activity modification, NSAIDs, splinting
- Operative decompression: compressive masses
Disposition
- Discharge with orthopedic follow up
See Also
External Links
References
- ↑ Dang AC et al. Unusual Compression Neuropathies of the Forearm, Part 2: Median Nerve. JHS. 2009;34A:1915-1920.