Portable tunnel syndrome with now repeat of symptoms. Pain. The median nerve is abnormally enlarged within the carpal tunnel, measuring nearly 30 sq mm at the level of the distal carpal row. Although there is loss of fat signal intensity within the carpal tunnel, I see no frank enhancement to indicate synovitis. Low signal intensity within the subcutaneous fat volar to the carpal tunnel may represent a surgical scar from prior carpal tunnel release. Bandlike low signal intensity extending from the hook of the hamate to the trapezium likely represents a combination of residual retinaculum and scarring and is bowed volarly. I see no mass within the carpal tunnel itself. A small (5 mm) collection of fluid signal intensity with minimal enhancement is situated between the volar lip of the distal radius and the overlying flexor pollicis longus tendon and likely represents a small ganglion, perhaps associated with the volar radiolunotriquetral ligament.The bones of the wrist appear normal. Minimal enhancement of the distal radioulnar joint may represent a very mild synovitis, but this is equivocal. A tiny focus of enhancement just distal to the membranous portion of the scapholunate ligament may represent focal synovitis or tiny ganglion, but is of questionable clinical significance. I otherwise see no specific findings to indicate a scapholunate or lunotriquetral ligament tear. Mild increased signal intensity within the medial fibers of the articular disc of the triangular fibrocartilage may reflect mild degeneration, but I see no fluid-filled tear. The tendons appear intact.
Abnormal enlargement of the median nerve within the carpal tunnel and other findings as described above.