Incidental bifid median nerve with a wandering ulnar division separated by the third flexor digitorum superficialis muscle: importance of ultrasound evaluation

Abstract

Ultrasound evaluation of the median nerve is commonly performed in patients with suspected carpal tunnel syndrome. Radiologists should be familiar with variant anatomy of the median nerve to assist clinicians in the management of these patients, particularly when surgery is being considered. A 63-year-old female was being evaluated for a ganglion cyst and was incidentally found to have a bifid median nerve with wandering ulnar division which coursed superficial to the third digit flexor digitorum superficialis (FDS) muscle belly. The patient did not have any symptoms of carpal tunnel syndrome so surgery has not been performed; however this case highlights the importance of ultrasound evaluation to avoid potential perioperative complications.

Keywords

• Bifid median nerve
• Flexor digitorum superficialis
• Musculoskeletal ultrasound