Skip to main content
Physiatry '26 Main banner
Final Program


Final Program

Electrodiagnostic / Neuromuscular Medicine

1614 - Carpal tunnel with right trifurcated median nerve

Friday, February 20, 2026
5:00 PM - 6:30 PM AST

    Presenting Author(s)

  • LA

    Luisa Alvarez, MS

    MS4
    Albert Einstein College of Medicine
    Elmhurst, New York, United States

  • IG

    Isabella Gibaldi, BA

    Medical Student
    Albert Einstein College of Medicine
    Bronx, New York, United States

    • Co-Author(s)

  • RF

    Ricardo Fuentes-Saavedra, MD

    Performing Arts Medicine Fellow
    UNT Health Fort Worth
    Irving, Texas, United States

  • SG

    Sikha Guha, MD

    Asst.Professor
    Montefiore Medical Center/albert Einstein College of Medicine
    Bronx, New York, United States

    • Submitter(s)

  • LA

    Luisa Alvarez, MS

    MS4
    Albert Einstein College of Medicine
    Elmhurst, New York, United States

Case Diagnosis: Carpal tunnel with right trifurcated median nerve

Case Description: We report a case of a 69-year-old male presenting with bilateral hand numbness and tingling who was incidentally found to have a trifurcated right median nerve and bilateral persistent median artery on neuromuscular ultrasound. Past medical history notable for non-insulin dependent Diabetes mellitus type II, coronary artery disease, and myocardial infarction. Presented for electrodiagnostic evaluation of CTS with a 10-year history of bilateral and progressive hand pain, weakness, nocturnal paresthesia, numbness and tingling. Physical exam revealed a positive Phalen’s test at the bilateral hands. Neuromuscular ultrasound revealed incidental findings of persistent median artery bilaterally and trifid median nerve on the right side inside the flexor retinaculum, with normal cross-sectional area at bilateral median nerve. The cross-sectional area of the right median nerve at the wrist was 0.07cm2, and the cross-sectional area of the left median nerve at the wrist was 0.10cm2.

Discussions: A variety of anatomical variations in the branching patterns of the median nerve of clinical significance have been described. Bifurcation of the median nerve is the most commonly described abnormality. Conversely, trifurcation of the median nerve is thought to be an especially rare variant, with very few published cases.

Conclusions: While considered to be rare, trifurcation of the median nerve is an important anatomic variant for clinicians to be aware of when treating carpal tunnel syndrome, especially for patients requiring surgical intervention.