Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of posttraumatic neuropathies

Publications

Share / Export Citation / Email / Print / Text size:

Journal of Ultrasonography

Polish Ultrasound Society (Polskie Towarzystwo Ultrasonograficzne)

Subject: Medicine

GET ALERTS

ISSN: 2084-8404
eISSN: 2451-070X

DESCRIPTION

2
Reader(s)
7
Visit(s)
0
Comment(s)
0
Share(s)

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue / page

Related articles

VOLUME 15 , ISSUE 60 (March 2015) > List of articles

Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of posttraumatic neuropathies

Berta Kowalska *

Keywords : ultrasonography,  posttraumatic peripheral neuropathies, diagnosis,  partial nerve injury,  complete nerve injury

Citation Information : Journal of Ultrasonography. Volume 15, Issue 60, Pages 15-28, DOI: https://doi.org/10.15557/JoU.2015.0002

License : (CC BY-NC-ND 4.0)

Received Date : 15-June-2014 / Accepted: 12-November-2014 / Published Online: 13-September-2016

ARTICLE

ABSTRACT

The primary aim of this paper was to assess the relevance of high-frequency ultrasound examination in qualifying patients for either surgical or conservative treatment of posttraumatic peripheral neuropathies. The study was conducted in a group of 47 patients aged 16–65 (mean age 33) who in 2009–2011 were referred to ultrasound examinations due to a clinical suspicion of posttraumatic peripheral neuropathies. The group included 30 females and 17 males. The patients examined presented with neuropathies of the following peripheral nerves: median, ulnar, common peroneal, digital, cutaneous in the deltoid area, mental, PIN and RSNR. In 21 patients, nerve injuries were partial, and in 24 – complete. In 2 cases, the nerve was entrapped between bony fragments. 17 of 21 patients with partial nerve injuries (80.95%) underwent an EMG examination. No functional tests were conducted in the cases of complete injuries when ultrasound imaging had confi rmed the result of the clinical examination. All patients underwent the interview, physical examination and ultrasound examination. Ultrasound examinations were performed with Esaote MyLab 50 and MyLab 60 systems using high-frequency broadband linear transducers: 6–18 MHz. The nerves were evaluated in the gray-scale and in the power Doppler mode in longitudinal and transverse sections for localization, morphology and the grade of injury as well as for possible anatomic variants of the nerve trunk and pathologies of the adjacent tissues. Moreover, a dynamic examination was performed, and it was attempted to induce pain or paresthesia by palpation at the site of the visualized pathology. Additionally, the motor and sensory–motor nerves were assessed indirectly based on the images of the skeletal muscles innervated by these nerves. The analyses of the collected material were performed by means of descriptive statistics. The results of clinical and surgical verifi cation were consistent with ultrasound fi ndings in 100% of cases. The results obtained indicate that high-frequency ultrasonography is a valuable method in qualifying patients for various types of treatment of peripheral neuropathies resulting from trauma.

Content not available PDF Share

FIGURES & TABLES

REFERENCES

1. Seddon H: Surgical Disorders of the Peripheral Nerves. Churchill Livingstone, Edinburgh 1975.
2. Sunderland S: Nerves and Nerve Injuries. Churchill Livingstone, Edinburgh 1978.
3. Martinoli C: Imaging of the peripheral nerves. Semin Musculoskelet Radiol 2010; 14: 461–462.
4. Bianchi S, Martinoli C: Ultrasonografi a układu mięśniowo-szkieletowego. Tom II. Medipage, Warszawa 2009.
5. Marhofer P: Zastosowanie ultrasonografi i w blokadach nerwów obwodowych. Zasady i praktyka. MedMedia, Warszawa 2010.
6. Kowalska B: Assessment of the utility of ultrasonography with highfrequency transducers in the diagnosis of entrapment neuropathies. J Ultrason 2014; 14: 371–392.
7. Banach M, Bogucki A (eds.): Zespoły z ucisku – diagnostyka i leczenie. Medycyna Praktyczna, Kraków 2003.
8. Żyluk A, Walaszek I, Szlosser Z: No correlation between sonographic and electrophysiological parameters in carpal tunnel syndrome. J Hand Surg Eur Vol 2014; 39: 161–166.
9. Lee D, van Holsbeeck MT, Janevski PK, Ganos DL, Ditmars DM, Darian VB: Diagnosis of carpal tunnel syndrome. Ultrasound versus electromyography. Radiol Clin North Am 1999; 37: 859–872.
10. Hayamizu K, Naito K, Ito K: Ultrasonography for traction injuries of the brachial plexus. Nihon Igaku Hoshasen Gakkai Zasshi 1995; 55:873–877.
11. Martinoli C, Serafi ni G, Bianchi S, Bertolotto M, Gandolfo N, Derchi LE:Ultrasonography of peripheral nerves. J Peripher Nerv Syst 1996; 1: 169–178.
12. Cokluk C, Aydin K, Senel A: Presurgical ultrasound-assisted neuroexamination in the surgical repair of peripheral nerve injury. Minim Invasive Neurosurg 2004; 47: 169–172.
13. Haber HP, Sinis N, Haerle M, Schaller HE: Sonography of brachial plexus traction injuries. AJR Am J Roentgenol 2006; 186: 1787–1791.

14. Bodner G, Buchberger W, Schocke M, Bale R, Huber B, Harpf C et al.:Radial nerve palsy associated with humeral shaft fracture: evaluation with US – initial experience. Radiology 2001; 219: 811–816.
15. Cartwright MS, Chloros GD, Walker FO, Wiesler ER, Campbell WW:Diagnostic ultrasound for nerve transection. Muscle Nerve 2007; 35:796–799.
16. Çokluk C, Aydin K: Ultrasound examination in the surgical treatment of lower extremity peripheral nerve injuries: part II. Turk Neurosurg 2007; 17: 197–201.
17. Zhu J, Liu F, Li D, Shao J, Hu B: Preliminary study of the types of traumatic peripheral nerve injuries by ultrasound. Eur Radiol 2011;21: 1097–1101.
18. Samardzić M, Grujicić D, Milinković ZB: Radial nerve lesions associated with fractures of the humeral shaft. Injury 1990; 21: 220–222.
19. Böstman O, Bakalim G, Vainionpää S, Wilppula E, Pätiälä H, Rokkanen P: Immediate radial nerve palsy complicating fracture of the shaft of the humerus: when is early exploration justifi ed? Injury 1985;16: 499–502.
20. Bodner G, Huber B, Schwabegger A, Lutz M, Waldenberger P: Sonographic detection of radial nerve entrapment within a humerus fracture. J Ultrasound Med 1999; 18: 703–706.
21. Martinoli C, Bianchi S, Pugliese F, Bacigalupo L, Gauglio C, Valle M et al.: Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound 2004; 32: 438–450.
22. Foxall GL, Skinner D, Hardman JG, Bedforth NM: Ultrasound anatomy of the radial nerve in the distal upper arm. Reg Anesth Pain Med 2007; 32: 217–220.
23. Rossey-Marec D, Simonet J, Beccari R, Michot C, Bencteux P, Dacher JN et al.: Ultrasonographic appearance of idiopathic radial nerve constriction proximal to the elbow. J Ultrasound Med 2004; 23: 1003–1007.
24. Gruber H, Peer S, Meirer R, Bodner G: Peroneal nerve palsy associated with knee luxation: evaluation by sonography – initial experiences. AJR Am J Roentgenol 2005; 185: 1119–1125.

EXTRA FILES

COMMENTS