Authors: Hicham El Hor, Mayo Clinic Nirusha Lachman, Mayo Clinic Punnose Kattil, Mayo Clinic Marianne Luetmer, Mayo Clinic Nicholas Rhodes, Mayo Clinic Peter Amadio, mayo clinic ,
The thenar eminence region has a complex anatomy. therefore, imaging of this area is challenging and not well describe in literature despite the important function of the thenar eminence muscles and the frequent conditions encountered in this region. In instance, the hand is exposed to trauma and to foreign body retention that represent 10% of hand injuries. Ultrasound has become the technique of choice not only for detecting but also for guiding removal of foreign bodies. therefore, there is necessity of being accurate in determining the exact foreign body location and identifying nearby neuro-vascular structures to ensure a safe procedure. We have conducted a study by combining dissection and sonographic analysis of cadaver hands, and by correlating these finding with the sonographic findings in living volunteers. We have detailed bony landmarks and specific muscle architecture that allow each thenar muscle belly to be identified individually by ultrasound. The course of the motor branch of median nerve (MBMN), princeps pollicis artery (PPA) and the superficial palmar branch of radial artery (SPBRA) in the thenar area were also identified sonographically and described. These findings were summarized in a step-by-step ultrasound protocol with specific landmarks to help integrate this exam in daily practice.