{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:37:45Z","timestamp":1782898665591,"version":"3.54.5"},"reference-count":59,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Wrist and hand anatomy may present several clinically relevant variants that involve bones, muscles, tendons, and nerves. Thorough knowledge of these abnormalities and their appearance in imaging studies is useful for proper management. In particular, it is necessary to differentiate the incidental findings that do not represent a trigger for a specific syndrome from those anomalies causing symptoms and functional impairment. This review reports the most common anatomical variants encountered in clinical practice and briefly discusses their embryogenesis, related clinical syndrome if present, and their appearance using different imaging techniques. The information each diagnostic study (ultrasonography, radiographs, computed tomography, and magnetic resonance imaging) may provide is described for each condition.<\/jats:p>","DOI":"10.1055\/s-0043-1761953","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T22:32:15Z","timestamp":1680561135000},"page":"169-181","source":"Crossref","is-referenced-by-count":3,"title":["Imaging of Anatomical Variants Around the Wrist and Hand"],"prefix":"10.1055","volume":"27","author":[{"given":"Federico","family":"Zaottini","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7450-6528","authenticated-orcid":false,"given":"Riccardo","family":"Picasso","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, 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Radiol"},{"issue":"05","key":"ref40","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S0363-5023(05)80444-7","article-title":"Anatomic investigation of the role of the lumbrical muscles in carpal tunnel syndrome","volume":"20","author":"D B Siegel","year":"1995","journal-title":"J Hand Surg Am"},{"issue":"08","key":"ref41","first-page":"1558","article-title":"Morphological study of lumbricals\u2014a cadaveric study","volume":"7","author":"K Parminder","year":"2013","journal-title":"J Clin Diagn Res"},{"issue":"11","key":"ref42","doi-asserted-by":"crossref","first-page":"825","DOI":"10.14740\/jocmr2243w","article-title":"Palmaris longus muscle's prevalence in different nations and interesting anatomical variations: review of the literature","volume":"7","author":"D Ioannis","year":"2015","journal-title":"J Clin Med Res"},{"issue":"02","key":"ref43","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/00000637-199808000-00024","article-title":"A clinical reminder: a palmaris longus muscle variation","volume":"41","author":"A Zeybek","year":"1998","journal-title":"Ann Plast Surg"},{"issue":"01","key":"ref44","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1186\/s12891-017-1901-x","article-title":"Anatomical variations of the palmaris longus muscle including its relation to the median nerve\u2014a proposal for a new classification","volume":"18","author":"\u0141 Olewnik","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"issue":"02","key":"ref45","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/ca.20747","article-title":"The palmaris longus muscle and its relations with the antebrachial fascia and the palmar aponeurosis","volume":"22","author":"C Stecco","year":"2009","journal-title":"Clin Anat"},{"issue":"06","key":"ref46","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/J.JHSB.2006.07.015","article-title":"The clinical significance of the palmaris longus tendon in the pathophysiology of 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Neumeister","year":"2005","journal-title":"Can J Plast Surg"},{"issue":"05","key":"ref50","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1054\/JHSB.1999.0237","article-title":"Anomalies of the flexor digitorum superficialis muscle","volume":"24","author":"D Elliot","year":"1999","journal-title":"J Hand Surg [Br]"},{"issue":"01","key":"ref51","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/1753193413478349","article-title":"Painful, palpable and pathological: anomalous flexor digitorum superficialis brevis in the palm, comparative anatomical context, and an updated classification of anomalies of the flexor digitorum superficialis","volume":"39","author":"W Bhat","year":"2014","journal-title":"J Hand Surg Eur Vol"},{"issue":"01","key":"ref52","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1055\/s-0041-1729130","article-title":"Performance evaluation of high-resolution ultrasound versus magnetic resonance imaging in diagnosing peripheral nerve 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