Isolated Palsy of the Anterior Interosseous Nerve to Flexor Pollicis Longus, Magnetic Resonance Imaging and Clinical Correlation

Abstract

Case: Anterior interosseous nerve (AIN) palsy is an uncommon, though well-described, clinical entity. When isolated to the thumb, it can be confused with atraumatic rupture of the flexor pollicis longus (FPL) tendon. A 57-year-old man experienced atraumatic onset of difficulty flexing the distal interphalangeal thumb joint. Magnetic resonance imaging (MRI) demonstrated denervation edema of the FPL, suggesting atypical AIN palsy. Resolution of symptoms and MRI findings occurred concomitantly with nonoperative treatment. Conclusion: Atypical AIN palsy limited to the FPL is a rare clinical entity whose diagnosis can be supported with MRI. Here, we report a successful case of nonoperative management.