CASE: A 17-year-old girl presented with chronic right arm numbness, cramping, burning pain, and weakness. Initial nerve studies showed slowing in the median and ulnar nerves, but an outside magnetic resonance imaging was negative. Repeat magnetic resonance neurography (MRN) revealed right C8 nerve root and lower trunk enlargement, compressed by a fibrous band from a small cervical rib. The lower trunk appeared indented in a "sickle" shape-termed the wedge-sickle sign. Surgery confirmed the MRN findings. CONCLUSION: MRN can depict the wedge-sickle sign previously seen only on ultrasound, potentially improving sensitivity of MRN for detecting thin fibromuscular bands in neurogenic thoracic outlet syndrome.
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Shakoor et al. (2026) studied this question.
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