Síndrome del pronator teres asociado a otras neuropatías compresivas en la extremidad superior. Serie de casos y revisión bibliográfica

Abstract

Introduction

Pronator teres syndrome (PTS) consists of compression of the median nerve between the heads of the pronator teres muscle. It is a rare pathology that is often confused with other compressive neuropathies on the upper extremity. We present three uncommon cases of PTS associated with nerve compressions on elbow and wrist.

Case 1

A 53-year-old male musician presented with paresthesias on the right upper limb. Electrophysiology showed entrapment of the median nerve in the wrist and the ulnar nerve in the elbow. Ultrasonography showed compression of the median nerve between the pronator teres heads. Patient improved with conservative treatment.

Case 2

A 41-year-old male delivery driver presented pain and loss of strength in the wrist and hand 3 months after surgery for a distal rupture of the right biceps brachialis. Ultrasonography showed compression of the ulnar nerve in the epitrocleolecranial canal. Electromyography showed entrapment of the median nerve at the elbow and wrist and the ulnar nerve at the elbow. He improved with NSAIDs and physical therapy.

Case 3

A 52-year-old male metal worker presented with epitrochlear pain, paresthesia and loss of strength in the right hand. Electromyography showed entrapment of the median and ulnar nerves at the elbow and the median nerve at the wrist. Conservative treatment did not reach a complete remission of symptoms.

Conclusion

PTS should be suspected in patients with sensory alterations in the upper limb. Differentiating it from other compressive neuropathies is essential since early detection allows effective conservative therapeutic measures to be applied.