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Peripheral Nerve Ultrasonography

Simon Podnar
OBJECTIVE: Although ultrasonographic (US) visualization of peripheral nerves is becoming more and more frequently used, there are few studies on its actual contribution to the diagnosis and management of patients with peripheral nerve disorders. METHODS: The electronic records of consecutive patients referred to our US laboratory over an eight-month period were retrospectively analyzed. The contribution of US examination to patient management was evaluated. RESULTS: Two hundred and thirty one consecutive patients (43% men) were analyzed...
February 4, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
Kunwarpal Singh, Kamlesh Gupta, Sukhdeep Kaur
Aim of the study: High-resolution ultrasonography of the tibial nerve is a fast and non invasive tool for diagnosis of diabetic peripheral neuropathy. Our study was aimed at finding out the correlation of the cross sectional area and maximum thickness of nerve fascicles of the tibial nerve with the presence and severity of diabetic peripheral neuropathy. Material and methods: 75 patients with type 2 diabetes mellitus clinically diagnosed with diabetic peripheral neuropathy were analysed, and the severity of neuropathy was determined using the Toronto Clinical Neuropathy Score...
December 2017: Journal of Ultrasonography
Zsuzsanna Arányi, Anita Csillik, Katalin Dévay, Maja Rosero
INTRODUCTION: Hypervascularization of nerves has been shown to be a pathological sign in some peripheral nerve disorders, but has not been investigated in nerve trauma. METHODS: An observational cohort study was performed of the intraneural blood flow of 30 patients (34 nerves) with penetrating nerve injuries, before or after nerve reconstruction. All patients underwent electrophysiological assessment, and B-mode and color Doppler ultrasonography. RESULTS: Intraneural hypervascularization proximal to the site of injury was found in all nerves, which was typically marked and had a longitudinal extension of several centimeters...
January 12, 2018: Muscle & Nerve
Johan A Telleman, Menno D Stellingwerff, Geert J Brekelmans, Leo H Visser
OBJECTIVE: To investigate development of sonographic abnormalities and applications of high-resolution ultrasonography (HRUS) in neurofibromatosis type 1 (NF1). METHODS: Sixteen asymptomatic or minimally symptomatic NF1 patients underwent HRUS at inclusion and 1 year follow-up. Upper and lower extremity nerves were investigated. Peripheral nerve involvement was graded. RESULTS: Plexiform neurofibromas (PNFs) were found in 7 patients (43...
November 26, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Park Jiyoung, Ok Seong-Ho, Han Jeong Yeol, Park Miyeong, Seo Eun Hui, Kim Yeon A
INTRODUCTION: The etiology of calf pain varies widely; therefore, it is difficult to diagnose and requires careful history taking and physical examination by primary care unit physicians. Because ultrasonography is easy to perform, cheap, and readily available with physicians during a routine consultation, it is the first choice of modality for the evaluation of calf pain. However, simple inflammation around the nerve should also be considered as a possible etiology. Here we describe a 35-year-old man with chronic pain in the right calf that was actually caused by fibroma-induced chronic inflammation around the tibial and peroneal nerves but misdiagnosed as centralized neuropathic pain...
December 28, 2017: Pain Practice: the Official Journal of World Institute of Pain
Kenichiro Furukawa, Yutaka Tanizawa, Kimihide Kusafuka, Noriyuki Nishiwaki, Keiichi Fujiya, Hayato Omori, Sanae Kaji, Makoto Hikage, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Etsuro Bando, Taiichi Kawamura, Masanori Terashima
BACKGROUND: Amputation neuromas (ANs) are reactive hyperplasia of nerve tissues that occur after a trauma or surgery involving the peripheral nerves. Only two previous reports of ANs occurring around the stomach and post gastrectomy have been reported. We report the case of a patient with AN near the remnant stomach who underwent distal gastrectomy for gastric cancer. CASE PRESENTATION: A 76-year-old man underwent distal gastrectomy, D1+ lymphadenectomy, and Billroth-I reconstruction for early gastric cancer in another hospital at 63 years of age...
December 12, 2017: Surgical Case Reports
James H Jones, Alison Brown, Daniel Moyse, Wenjing Qi, Lance Roy
BACKGROUND: Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. OBJECTIVE: We hypothesized that occipital neurostimulator (ONS) leads placed with ultrasonography combined with fluoroscopy would demonstrate increased survival rates and times when compared to ONS leads placed with fluoroscopy alone...
November 2017: Pain Physician
Hiroaki Matsuda, Yoshinari Oka, Ryuichi Yoshida, Yuki Katsura, Hidemi Takeuchi, Yasuo Fujimoto, Shigeko Takatsu, Masashi Miyazaki
INTRODUCTION: Arteriovenous access (AVA)-related pain treated successfully with runoff-venous decompression of the causative nerve, following ultrasound (US)-assisted preoperative evaluation, has never been reported. CASE PRESENTATION: A 57-year-old man suffering from constant exhausting pains along the outflow cephalic vein of the radiocephalic arteriovenous fistula at the wrist and the antecubital fossa, was treated surgically after the diagnosis of AVA-related pain derived from cephalic vein compression on two peripheral cutaneous nerves, the superficial radial nerve (SRN) and the lateral antebrachial cutaneous nerve (LACN)...
November 9, 2017: Journal of Vascular Access
Hannes Wegscheider, Gerd Fabian Volk, Orlando Guntinas-Lichius, Bernhard Moriggl
The technical advances in sonography of the past decade have supported the rapid improvement of high-resolution imaging, which enables the quick visualization of peripheral nerves at relatively limited costs. Recently, the possibility of visualizing the extratemporal facial nerve (FN) has been considered. This manuscript describes the first systematic evaluation in cadavers, of a novel ultrasonographic approach with this specific aim. Eight cadaveric hemifaces were evaluated by means of high-frequency ultrasound with two linear (13 and 22 MHz) and a convex transducer (6...
November 10, 2017: European Archives of Oto-rhino-laryngology
Jun Chen, Chun-Lei Wang, Shan Wu, Shan He, Jun Ren
OBJECTIVE: The aim of this study was to investigate the usefulness of high-resolution ultrasonography for the diagnosis of polyneuropathy in diabetes mellitus patients by the examination of the ulnar nerves. METHOD: We recruited 100 healthy age-matched volunteers (50 women and 50 men) with 200 arms without diabetes or cubital tunnel syndrome as the control group. We assessed the upper limbs of 100 diabetes mellitus patients (45 women and 55 men), 40 of whom had electrophysiologically confirmed diabetic peripheral neuropathy and 60 had no diabetic peripheral neuropathy in the upper limbs...
September 2017: Journal of Ultrasonography
A Picelli, S Tamburin, G Berto, E Chemello, Marialuisa Gandolfi, Leopold Saltuari, Andreas Waldner, Nicola Smania
To better understand the effects of spasticity on peripheral nerves, we evaluated the electrodiagnostic and nerve ultrasonographic features of the median and ulnar nerves in adults with upper limb spasticity. Twenty chronic stroke patients with spastic hemiparesis underwent nerve conduction study and nerve ultrasonography of the median and ulnar nerves at both upper limbs. Affected versus unaffected upper limb comparisons showed significant differences in the median and ulnar nerve distal motor latencies, compound muscle action potentials and F-wave minimal latencies...
July 2017: Functional Neurology
Stefano Bianchi, Laure Droz, Catherine Lups Deplaine, Victor Dubois-Ferriere, Marino Delmi
Ultrasonography (US) of peripheral nerves has gained wide popularity because of the increased definition of modern high-frequency electronic transducers, as well as the well-known advantages of US, which include easy availability, low cost, and the possibility of realizing a dynamic examination. Traditionally, US has been deployed to assess the major nerves of the limbs. More recently, US has also been used to assess the normal appearance and pathologic changes of smaller subcutaneous nerves. The sural nerve is a small sensory nerve in the subcutaneous tissues of the calf that can be affected by a variety of disorders...
October 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Francis O Walker
PURPOSE OF REVIEW: High-resolution ultrasound has made it possible to view most nerves and muscles in real time and to identify pathologic change in size, echo texture, and vascularity. This article focuses on the principles underlying ultrasound imaging and the application of ultrasound imaging to clinical disorders commonly seen in an electrodiagnostic laboratory. RECENT FINDINGS: Ultrasound is a sensitive and specific tool for evaluating myopathic and neurogenic muscle disease...
October 2017: Continuum: Lifelong Learning in Neurology
Patrick J Battaglia, Vivian Carbone-Hobbs, Gary M Guebert, Susan E Mackinnon, Norman W Kettner
Peripheral nerve tumors are often evaluated with magnetic resonance imaging (MRI), although there are many advantages offered with high-resolution ultrasonography (HRUS). This case report emphasizes the value of HRUS in the diagnosis and management of a patient with a cystic radial nerve Schwannoma. In addition, information on tumor stiffness, obtained with shear-wave sonoelastography (SWE), is presented.
September 2017: Journal of Ultrasound
Basak Mansiz-Kaplan, Merve Akdeniz-Leblecicier, Ilker Yagci
OBJECTIVE: To evaluate the relationship between extramedian spreading of sensorial symptoms and median and ulnar nerve cross-sectional area (CSA) and to compare the ultrasonographic and electrophysiological findings in patients with carpal tunnel syndrome (CTS) with or without extramedian sensory symptoms. DESIGN: Cross-sectional study. MATERIALS AND METHODS: Patients with CTS were divided into two groups as with or without extramedian symptoms and were assessed clinically, electrophysiologically and ultrasonographically by three blind investigators...
August 10, 2017: Journal of Electromyography and Kinesiology
Daniel Mok, Stephan K W Schwarz, Kevin Rondi
PURPOSE: Point-of-care ultrasonography (POCUS) is a useful tool with multiple perioperative applications relevant to the anesthesiologist. Nevertheless, the full scope of POCUS applications has yet to be formally incorporated into Canadian anesthesiology training. The purpose of this study was to determine the current state of POCUS training in Canadian anesthesiology residency programs. METHODS: We conducted a web-based survey of program directors from Royal College-accredited anesthesiology residency programs across Canada...
October 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Büşra Can, Murat Kara, Özgür Kara, Zekeriya Ülger, Walter R Frontera, Levent Özçakar
The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions)...
December 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Johan A Telleman, Menno D Stellingwerff, Geert J Brekelmans, Leo H Visser
INTRODUCTION: Neurofibromatosis type 2 (NF2) is mainly associated with central nervous system (CNS) tumors. Peripheral nerve involvement is described in symptomatic patients, but evidence of subclinical peripheral nerve involvement is scarce. METHODS: We conducted a cross-sectional pilot study in 2 asymptomatic and 3 minimally symptomatic patients with NF2 to detect subclinical peripheral nerve involvement. Patients underwent clinical examination, nerve conduction studies (NCS), and high-resolution ultrasonography (HRUS)...
June 29, 2017: Muscle & Nerve
Samer Narouze, Dmitri Souzdalnitski
BACKGROUND: Complex regional pain syndrome (CRPS) comprises a group of conditions characterized by severe, debilitating pain that is disproportionate to any inciting event and is not distributed in a specific nerve distribution or dermatome. CASE REPORT: A 42-year-old female with a 2-year history of right upper extremity CRPS type I refractory to conventional management underwent an ultrasound-guided and fluoroscopy confirmed percutaneous peripheral nerve stimulation trial with a lead extending from the C6 to the T3 level to cover the cervical and upper thoracic sympathetic chain...
2017: Ochsner Journal
Shilpa Domkundwar, Gayatri Autkar, S V Khadilkar, Mayur Virarkar
PURPOSE: Nerve disorders are commonly encountered in clinical practice. Ultrasonography (USG) is a useful modality in the evaluation of most of the peripheral and superficial pathologies amenable to penetration by ultrasound. The primary objective is to study the USG findings of various peripheral nerve pathologies and to correlate them with electrophysiological (EMG-NCV) findings. METHOD: 42 patients referred with suspicion of peripheral nervous system affection were evaluated with USG along with EMG-NCV...
June 2017: Journal of Ultrasound
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