Pronator teres syndrome: median nerve anatomy

In the proximal forearm the median nerve crosses several structures that can narrow its path: the bicipital aponeurosis, the two heads of pronator teres and the arch of flexor digitorum superficialis. This page places them on the 3D model and on the ultrasound image.

Anatomy of the passage

Pronator teres region — Plate derived from Z-Anatomy / BodyParts3D · CC BY-SA 4.0

In the proximal forearm, the median nerve passes between the heads of pronator teres. Compression by the bicipital aponeurosis and by the arch of flexor digitorum superficialis is also described. These are proximal sites that must be differentiated from the carpal tunnel.

Nerve: Median nerve: carpal tunnel and pronator
Frequency: Described site, less commonly seen.
Type of evidence: Anatomical and clinical review

References

Choi SJ, Ahn JH, Ryu DS, Kang CH, Jung SM, Park MS, Shin DR. Ultrasonography for nerve compression syndromes of the upper extremity. Ultrasonography 2015. PubMed 25682987 · DOI

Ultrasound landmarks

On the anterior aspect of the proximal forearm, the nerve passes between the superficial and deep heads of pronator teres and then beneath the arch of flexor digitorum superficialis. The brachial artery and its branches lie close by.