11/20/2023 0 Comments Lacertus syndromeSeveral case studies exist to document the lacertus fibrosus as a potential site of median nerve entrapment. It can occur on one side or be bilateral.Īll patients who report numbness, tingling, muscle loss, or loss of strength, dexterity, or manual endurance should be examined and tested not only for carpal tunnel syndrome, but also for lacertus syndrome.īecause lacertus syndrome is still widely unknown, its diagnosis is largely based on the knowledge and experience of the clinician consulted. Lacertus Fibrosus Compression The lacertus fibrosus, or bicipital aponeurosis, ex-tends obliquely from the biceps tendon across the antecubital fossa to the fascia overlying the flexor forearm muscles22 (Figure 4). Lacertus syndrome is a proximal median nerve. The electromyogram (EMG) rarely detects lacertus syndrome, but can be useful in diagnosing associated carpal tunnel syndrome. Essentially, lacertus syndrome (LS) is a subset of pronator syndrome and an uncommon and controversial diagnosis. The test consists of comparing the resistance force of the lateral rotators by stimulating (scratching) the suspected compression zone. The scratch collapse test is not a very well-known provocative maneuver, but very useful in confirming the diagnosis. It turns out the Lacertus Syndrome (a fairly rare condition, often seen in throwing athletes) is an unnecessary band that was restricting the muscle in my forearm and keeping it from expanding when it was exercised. Partial resolution or persistence of symptoms in a patient operated on for a carpal tunnel very often means that the site of the compression has not been properly identified or that there is a second area of compression.ĭiagnosis is based primarily on examination and systematic physical examination of the entire upper limb, not just the wrist. I finally talked to a surgeon a couple of weeks ago, who diagnosed me with both Golfers Elbow and Lacertus Syndrome. Key Words: anatomic variances, anterior interosseous syndrome, carpal tunnel syndrome, lacertus syndrome, median nerve compression, pronator syndrome. This misdiagnosis is a very common cause of carpal tunnel surgery failure. Unfortunately, few clinicians have the knowledge to suspect and investigate lacertus syndrome. It manifests with symptoms very similar to carpal tunnel syndrome, so its diagnosis is often overlooked or made late. Its symptoms are frequently confused with those of carpal tunnel syndrome, which complicates the differential diagnosis and management of the patient. Lacertus syndrome is a common nerve disorder, but it is still widely unknown to the public and many physicians. It is rare compared to compression at the wrist (carpal tunnel. Clinical diagnosis and wide-awake surgical treatment of proximal median nerve entrapment at the elbow: a prospective study. Lacertus syndrome has been well described by Hagert ( Hagert E. Because it is a rather unknown and non-documented condition, lacertus syndrome presents a particular diagnostic challenge. Pronator teres syndrome is a compression neuropathy of the median nerve at the elbow. Lacertus tunnel syndrome is a compression of the median nerve which occurs under a sheet of ligamentous tissue (lacertus fibrosus) just past the elbow joint.
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