case_images: PMC5532760_01
case_images: (a) Visible swelling in the right distal volar forearm on clinical examination; (b) An axial section of an MRI scan clearly demonstrating a superficial muscle belly at the level of the distal radio-ulnar joint in keeping with a reversed palmaris longus (*); (c) A sizeable reversed palmaris longus muscle belly in right distal volar forearm.
case_images: icrp_a_1353424_f0001_c.jpg
case_images: PMC5532760_01_icrp_a_1353424_f0001_c.jpg
case_images: F0001
case_images: Clinical examination revealed a visible swelling in the right volar forearm (Figure 1(a)), which co-located with the site of the discomfort. An MRI scan of the forearm was initially reported as unremarkable, but request was made for review of the images, and a RPL was identified (Figure 1(b)). The operation was carried out uneventfully under general anaesthetic, and a sizeable palmaris longus muscle belly was identified and excised through a longitudinal incision (Figure 1(c)).
case_images: PMC5532760_02
case_images: A longitudinal section of an ultra-sound clearly demonstrating a reversed palmaris longus muscle belly (*) lying onto of the flexor retinaculum. The deep flexor tendons ( ) and radial carpal joint lie inferiorly.
case_images: icrp_a_1353424_f0002_b.jpg
case_images: PMC5532760_02_icrp_a_1353424_f0002_b.jpg
case_images: F0002
case_images: An USS-scan was requested, which demonstrated a reversed palmaris muscle at the site of the discomfort (Figure 2) and identified no other potential causes of the pain.