Anterior interosseous neuropathy: Difference between revisions
No edit summary |
|||
| Line 17: | Line 17: | ||
==Clinical Features== | ==Clinical Features== | ||
*May have forearm pain although not as common in other median nerve compression syndromes | *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) | *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) | *Inability to hold a piece of paper between index and thumb fingertips (can't make "OK" sign) | ||
| Line 45: | Line 45: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 18:15, 5 August 2020
Background
- Anterior interosseous nerve (C5-T1) 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.