What is anterior interosseous nerve palsy?
Anterior interosseous nerve syndrome (AINS) is a rare condition characterized by motor deficits without sensory loss. AINS can be caused by compression neuropathy or brachial plexus neuritis, which leads to nerve inflammation and nerve damage. It results from the compression or injury of the anterior interosseous nerve, a branch of the median nerve that innervates specific muscles in the forearm and hand.
Typically, patients present with weakness in the thumb, index, and middle fingers, making it difficult to perform tasks that require fine motor skills, such as pinching or making an “O.K.” sign.
Diagnostic tests for anterior interosseous nerve syndrome
The diagnosis of AINS often involves clinical tests such as the pinch grip test (Froment’s sign) and the O.K. sign test. In the pinch grip test, the patient is asked to hold a piece of paper between their thumb and index finger while the examiner tries to pull it away. If the patient is unable to maintain the grip or if they flex their thumb IP joint instead of their MCP joint, it may indicate damage to AIN.
Meanwhile, in the O.K. sign test, the patient is asked to make an “O.K.” sign with their hand by touching their thumb to their index finger while extending their remaining fingers. If the patient is unable to form the shape or if they have difficulty keeping their fingertips together, it may indicate weakness in the AIN-innervated muscles.
In addition to these clinical tests, electromyography (EMG) and nerve conduction studies (NCS) can also be used to diagnose AINS. These tests involve stimulating the AIN and recording its activity in different muscles of the forearm. Abnormal results on these tests, such as reduced nerve conduction velocity or abnormal muscle activity, can indicate damage to the AIN.
Other imaging techniques, such as MRI or ultrasound, may also be used in some cases to assess the nerve and surrounding structures for any abnormalities. These tests can help identify potential causes of AINS, such as compression or entrapment of the nerve.










