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Ultrasound-guided median nerve hydrodissection of pronator teres syndrome: a case report and a literature review

Parham Shojaie1, Rajesh Botchu2, Karthikeyan Iyengar3, Elena Drakonaki4, Gaurav Kant Sharma5

Affiliation and address for correspondence
J Ultrason 2023; 23: e165–e169
DOI: 10.15557/JoU.2023.0026
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Abstract

Aim of the study: To describe the sonographic appearance of pronator teres syndrome and the role of ultrasound-guided hydrodissection for its management. Case description: Pronator teres syndrome is a wellknown compressive neuropathy of the median nerve between the two heads of pronator teres. However, the clinical presentation of this syndrome can be indolent with vague pain at the proximal volar forearm leading to a delay in diagnosis. We describe our experience in the management of pronator teres syndrome in a healthy young badminton player with ultrasound-guided median nerve hydrodissection. We highlight the clinical presentation, the role of dynamic Ultrasound scan (USS) in the diagnosis and effective treatment of pronator teres syndrome. Conclusions: In conclusion, managing PTS can be challenging, and this case highlights the importance of ultrasound-guided hydrodissection, when conservative measures have failed to improve the symptoms. Further studies are required to assess and compare the long-term outcomes of these interventions.

Keywords
ultrasonography; median neuropathy; nerve compression syndromes; nerve hydrodissection; interventional ultrasonography
Hydrodissection video of median nerve