Median nerve variation MRI

  • Research type

    Research Study

  • Full title

    Normal variation in position and cross-sectional profile of the median nerve.

  • IRAS ID

    230839

  • Contact name

    Nimalan Sanmugalingam

  • Contact email

    nimalan.sanmugalingam@nnuh.nhs.uk

  • Sponsor organisation

    Norfolk and Norwich University Hospital

  • Duration of Study in the UK

    0 years, 3 months, 30 days

  • Research summary

    Our anecdotal observation from reporting clinical MRI examinations of the wrist is that the position of the median nerve within the carpal tunnel may be highly variable. This variability also includes the relationship to neighbouring flexor tendons and the flexor retinaculum.

    Previous published research has examined the anatomical variation of the median nerve and in particularly its branches in the wrist and hand and has led to a number of classification systems. There have been cadaveric studies looking at the median nerve in relation to the flexor retinaculum but these studies are limited in number. There is limited data looking at the anatomical variance on cross sectional imaging. We hypothesize that there is variation in its position within the canal and its relationship to adjacent structures that have not previously been described.

    Accurately locating the variations in the position of the median nerve and its associating structures could lead the way in understanding those who are at risk of developing carpal tunnel syndrome. This could also provide better understanding for the surgeons regarding their approach to the carpal tunnel when performing a carpal tunnel release or other wrist operations.

    The aim is to perform a retrospective cross-sectional study using Magnetic Resonance Imaging (MRI) cases from the Norfolk & Norwich University Hospital PACS image archive. For each wrist the X-Y coordinate of the median nerve within the carpal tunnel will be recorded and its relation with neighbouring flexor tendons. Secondly we aim to calculate the prevalence of each variation that we encounter thus providing a distribution of the possible normal variances.

    No patients would be required to be recruited to this study. There would be no intervention in the patients’ treatment. The research team consider this to be a low risk study.

  • REC name

    East of England - Essex Research Ethics Committee

  • REC reference

    18/EE/0022

  • Date of REC Opinion

    16 Jan 2018

  • REC opinion

    Favourable Opinion