Practical Considerations for Ultrasound-Guided Hydrodissection in Pronator Teres Syndrome
King Hei Stanley Lam, Wai Wah Lai, Ho Yin Ngai, Wing Keung Ricky Wu
Abstract
We have read the recently published article titled “Ultrasonography in Pronator Teres Syndrome: Dynamic Examination and Guided Hydrodissection” by Chang et al. with great interest [1]. We appreciate the authors for raising awareness about an important but frequently neglected cause of median nerve (MN) entrapment in the pronator tunnel. The sonoanatomy of the pronator tunnel has been well described in this article. The use of dynamic ultrasound (US) to visualize and document the abnormal tethering of the MN to the ulnar head of the pronator teres (UHPT) was also well delineated. The authors speculated that this abnormal tethering is likely caused by abnormal adhesion or friction between the posterior surface of the MN and the fascia of the UHPT, leading to MN entrapment symptoms. In the Supplementary Data of their article, Chang et al. beautifully pointed out that the long axis of the MN moved synchronously with the...