Ters Palmaris Longus: Ön Kolda Benign Bir Şişlik Nedeni

Year 2022, , 20 - 23, 30.04.2022

Tuba Akdağ , Aynur Turan , Can Emre Baş

https://doi.org/10.35514/mtd.2022.63

Abstract

ÖZET

Normal bir anatomik yapı olarak palmaris longus kası, humerusun medial epikondilinden köken alır ve ön kol boyunca ilerleyerek distalde fleksör retinakulumu geçtikten sonra yüzeyel bir tendon olarak palmar aponevroza yapışır. Bu normal palmaris longus kas anatomisinin tam tersi olarak, ters palmaris longus proksimalde tendinöz bir kısma ve distalde kaslı bir kısma sahiptir. Ters palmaris longus nadir görülen bir kas anomalisidir. MRG'de, ters palmaris longus kasına ait kas öbeği fleksör karpi radialis tendonunun medialinde, ön kol volar yönünde tüm sekanslarda kas ile eş sinyalli olarak karşımıza çıkmaktadır. Bu anatomik varyantın ultrason ve MRg görünümüne aşina olmak ve görüntüleme bulgularını doğru bir şekilde tanımlamak, tedavi kararlarına rehberlik etmek ve tedavi sonuçlarını optimize etmek için esastır.

Keywords

Palmaris longus, kas, ters, ultrason, manyetik rezonans görüntüleme

Reverse Palmaris Longus: A Benign Cause of Swelling on The Forearm

Abstract

ABSTRACT

As a normal anatomic structure, the palmaris longus muscle originates from the medial epicondyle of the humerus and descends obliquely through the wrist. It has a flattened tendon distally and, after passing over the flexor retinaculum, inserts to the palmar aponeurosis superficially. As the exact opposite of this normal anatomy of palmaris longus muscle, reversed palmaris longus (RPL) has a tendinous part proximally and a muscular portion distally. RPL is a rare muscular abnormality. On MRI, RPL muscle belly is typically evident at the volar aspect of forearm, medial to the flexor carpi radialis tendon, which is of muscle signal on all sequences. Familiarity with the variant, ultrasound and MRI appearance of RPL and accurately describing relevant imaging findings is essential for guiding effective management decisions and optimizing treatment outcomes.

Keywords

Palmaris longus, muscle, reversed, ultrasound, magnetic resonans imaging

References

• 1. Wood J IV. Variations in human myology observed during the winter session of 1866-67 at King’s college, London (1867). Proc R Soc Lond 15:518–546
• 2. Giunta R, Brunner U, Wilhelm K Bilateral reversed palmaris longus muscle—a rare cause of peripheral median nerve compression syndrome. Case report. (1993) Unfallchirurg 96:538–540.
• 3. Longhurst G, Stone D, Mahony N. Bilateral reversed palmaris longus muscle: a case report and systematic literature review. Surg Radiol Anat. 2019 Nov 12. doi:10.1007/s00276-019-02363-z. [Epub ahead of print] Review. PubMed PMID: 31720753.
• 4. Park MJ, Namdari S, Yao J. Anatomic variations of the palmaris longus muscle. Am J Orthop (Belle Mead NJ) 2010; 39:89-94
• 5. Murabit A, Gnarra M, Mohamed A. Reversed palmaris longus muscle: Anatomical variant- case report and literature review. Can J Plast Surg. 2013. Spring;21(1):55-6. PubMed PMID: 24431941; PubMed Central PMCID: PMC3891100
• 6. Kopkin R, Gimenez C, Rudman E. A teenager presenting with a forearm mass. Reversed palmaris longus. Skeletal Radiol. 2017 Oct;46(10):1397-1398, 1459-60. doi: 10.1007/s00256-017-2717-3. PubMed PMID: 28733829.
• 7. Twoon M, Jones CD, Foley J, Davidson D. Reversed palmaris longus muscle: a report of two cases. Case Reports Plast Surg Hand Surg. 2017 Jul 24;4(1):73-76. doi: 10.1080/23320885.2017.1353424. eCollection 2017. PubMed PMID: 28804743; PubMed Central PMCID: PMC5532760.
• 8. Schuurman AH, van Gils AP. Reversed palmaris longus muscle on MRI: report of four cases. Eur Radiol. 2000;10(8):1242-4. PubMed PMID: 10939482.
• 9. Kikano, R., Charbel, C., Assi, C. et al. Prevalence, variants, and morphometrics of Palmaris Longus tendon: a magnetic resonance imaging study. Surg Radiol Anat 43, 749–753 (2021). https://doi.org/10.1007/s00276-020-02608-2
• 10. Linda D, Harish S, Stewart B, Finlay K, Parasu N, Rebello R. Multimodality imaging of peripheral neuropathies of the upper limb and brachial plexus. Radiographics. 2010; 30:1373–400.
• 11. Getzmann, J. M., & Schweizer, A. (2018). Surgical Resection of a Reversed Palmaris Longus Muscle Causing Chronic Exertional Compartment Syndrome in a Competitive Swimmer: A Case Report. Orthopaedic journal of sports medicine, 6(5), 2325967118769615. doi:10.1177/2325967118769615