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The authors show clear anatomical photographs of this accessory muscle along with an algorithm for investigating suspected anatomical variations.A-0285 Radiographic prediction of lunate morphology: reliability, reproducibility, and compatibility with MR arthrography Ji Hun Park, Tae Wook Kang, Seul Gi Kim, Young Woo Kwon, Jong Woong Park College of Medicine, Korea University Anam Hospital, Seoul, South Korea Background: Two major lunate types have been proposed on the basis of the absence (Type I) or presence (Type II) of medial facets.Methods: Plain radiographs of a total of 150 wrists were reviewed by three observers.The lunate types were independently evaluated twice using both PA analysis (Lunate Types I and II) and CTD analysis (Lunate Types I, CTD≤2mm; II, CTD≥4 mm; Intermediate, Others).The swelling increased in size and his overall hand function decreased, so surgical exploration was planned.At operation, the FDP tendon to the index finger and the intrinsic muscles were intact and of normal appearance.On the CTD analysis, 76 (50.7%) of the total wrists were classified into the intermediate group; excluding them, 27 of 29 Type II lunates (93.1%) and 39 of 45 Type I lunates (86.7%) were compatible with the MRA findings.Conclusions: Both systems had moderate inter-observer and intra-observer reliabilities.

A tendon ran proximally from this accessory muscle belly into the forearm.

While most anomalous muscles are asymptomatic, ours was causing symptoms particularly due to underlying muscle spasticity.

The other clinical relevance of this is that the ring finger FDP usually supplied by the ulnar nerve was in this instance supplied by the median nerve.

Anomalous or accessory FDS muscles in the palm are rare, but when present they can be painful and interfere significantly with hand function.

We present the case of a 28 year old male mechanic who presented with a painful swelling over his right thenar eminence following a road traffic accident.Anomalous and accessory muscles in the palm are anatomical curiosities until they become symptomatic.Accessory FDS muscles presenting in the palm are rare and only a few cases have been reported in the literature since they were first described in 1970 by Vichare.His grip strength was compromised and had reduced abduction of his index finger. No intrinsic muscle rupture was detected and no mass lesion was detected.