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Introduction <p>Carpal tunnel syndrome (CTS) is typically caused by increased pressure within the carpal tunnel; however, rare anatomical variants can also contribute to median nerve compression. Among these, the <i>palmaris profundus</i> muscle represents an uncommon intratunnel anomaly that can complicate both diagnosis and surgical management.</p> Case Presentation <p>We report a case of CTS in a 56-year-old woman in whom an aberrant muscle was identified intraoperatively during surgical decompression. The patient had undergone preoperative MRI to evaluate mild distal forearm swelling; however, the anomalous muscle was not visualized, even upon postoperative review by a senior musculoskeletal radiologist. The muscle was excised, resulting in satisfactory decompression of the median nerve. Unfortunately, the patient was lost to follow-up, and postoperative symptom resolution could not be evaluated.</p> Conclusions <p>This case emphasizes the importance of considering rare anatomical variants, such as the <i>palmaris profundus</i>, in patients with CTS. Even Preoperative imaging may fail to identify these anomalies; therefore, intraoperative vigilance is crucial to achieve complete median nerve decompression and prevent persistent or recurrent symptoms.</p>

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Carpal Tunnel Syndrome Caused by Palmaris Profundus: Case Report and Overview of Rare Anatomical Variants

  • 期刊论文

  • 发表日期：

    2025年12月6日

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  • Saab Almistarihi,
  • Ahmad Almigdad,
  • Ghandi Almanasir,
  • Motaz Qasaimeh,
  • Saad Haddad

摘要

Introduction

Carpal tunnel syndrome (CTS) is typically caused by increased pressure within the carpal tunnel; however, rare anatomical variants can also contribute to median nerve compression. Among these, the palmaris profundus muscle represents an uncommon intratunnel anomaly that can complicate both diagnosis and surgical management.

Case Presentation

We report a case of CTS in a 56-year-old woman in whom an aberrant muscle was identified intraoperatively during surgical decompression. The patient had undergone preoperative MRI to evaluate mild distal forearm swelling; however, the anomalous muscle was not visualized, even upon postoperative review by a senior musculoskeletal radiologist. The muscle was excised, resulting in satisfactory decompression of the median nerve. Unfortunately, the patient was lost to follow-up, and postoperative symptom resolution could not be evaluated.

Conclusions

This case emphasizes the importance of considering rare anatomical variants, such as the palmaris profundus, in patients with CTS. Even Preoperative imaging may fail to identify these anomalies; therefore, intraoperative vigilance is crucial to achieve complete median nerve decompression and prevent persistent or recurrent symptoms.