Not your average Saturday night palsy–High resolution nerve ultrasound resolves rare cause of wrist drop

•We present a case of acute wrist drop caused by radial nerve torsion.•High-resolution ultrasound was able to visualize the nerve constriction.•Nerve torsion is a rare differential diagnosis to Saturday night palsy.•Ultrasound may subject these patients early to surgical therapy. We present a case of a patient with acute wrist drop caused by radial nerve torsion. NCS showed axonal lesion of the radial nerve. High-resolution ultrasound was able to visualize a constriction of the radial nerve. Nerve torsion is a rare differential diagnosis to Saturday night palsy. The patient was subjected to early surgical intervention and showed a favorable outcome in follow-up. Thus, high-resolution ultrasound may subject these patients early to surgical therapy.