Images in Clinical Medicine
Processus Supracondylaris Humeri
N Engl J Med 2010; 362:739February 25, 2010
- Article
A 24-year-old man presented with a 6-month history of paresthesia and numbness of the right hand. On clinical examination, paresthesia in the region of the right median nerve was elicited on elbow extension. Radiography of the right elbow revealed a supracondylar process of the humerus (processus supracondylaris humeri) (arrow). A supracondylar process of the humerus is an outgrowth of bone originating from the anterior–medial cortex of the distal humerus. It occurs in approximately 0.4 to 2.0% of whites and less frequently in blacks. It can measure up to 20 mm in length and is a congenital human anatomical variation that may be related to a homologous structure normally found in amphibians, reptiles, and mammals. In rare cases, this process is joined to the medial epicondyle by a fibrous band of tissue, to form a canalis supracondylaris. The median nerve and the brachial artery can pass through the canalis supracondylaris and become trapped, resulting in the median-nerve entrapment syndrome, which was diagnosed in this patient. When the syndrome is confirmed, a resection of the supracondylar process can be performed. This patient chose not to go undergo surgery at that time. The symptoms were treated through a nonsurgical approach based on physical therapy, resulting in moderate relief.
Franck Billmann, M.D., Ph.D.
St. Vincentius Kliniken, Karlsruhe, Germany
franck.billmann@wanadoo. fr
