Ultrasound diagnosis of three different types of carpal tunnel syndrome associated with persistent median artery: A case report and literature review

Rationale: Carpal tunnel syndrome (CTS) is the most common neuropathy worldwide. Although multiple factors contribute to CTS, persistent median artery (PMA)-related CTS is relatively uncommon. To date, no literature has reported the ultrasonic features of different types of PMA-induced CTS. Patient concerns: We report the clinical manifestations and ultrasonographic features of 3 patients with different types of CTS associated with PMA and review relevant literature. Diagnoses: All 3 cases were diagnosed with PMA combined with CTS, specifically categorized as CTS with PMA thrombosis, CTS with PMA and median nerve bifidity, and CTS with PMA and high bifurcation of the median nerve. Interventions: Different treatment measures were administered based on ultrasound diagnosis and clinical presentation, all with good prognoses. Lessons: Ultrasound enables precise and rapid identification of various PMA-related types of CTS, effectively guiding clinicians in making the most patient-friendly treatment decisions.