35F 1 month wrist pain radiating to the shoulder, MRI

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The history is unhelpful

35F wrist pain radiates to the shoulder 18347430R.jpg

Image quality isn’t the best…I wondered if this was a tendon…didn’t really look like the median nerve…

35F wrist pain radiates to the shoulder 18347430R (1).jpg

GRE image on the left looks pretty convincing for vessel thrombosis, with perivascular edema in the Cor PDFS

35F wrist pain radiates to the shoulder 18347430R (2).jpg

I believe the red arrow indicates a thrombosed Median artery

I think the median nerve is bifid (yellow arrows), the image on the right shows slight bright signal in the larger moiety

I recommended US to confirm…but is that necessary?

Can it be anything else?

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1 thought on “35F 1 month wrist pain radiating to the shoulder, MRI”

  1. OCAD
    OCAD

    Based on the feedback, I see that everyone is convinced that this is a thrombosed median artery and bifid median nerve.

    Atul Taneja commented: Completely agree: Bifid median nerve with thrombosed persistent median artery.
    Don’t think the US is necessary at this moment. But would be interesting for post-treatment follow up

    Philip Wong offered a very practical point: I do like to confirm with ultrasound! Especially to convince the orthopedist of the diagnosis.

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