Magnetic Resonance Imaging in Non-Traumatic Canalicular Peripheral Neuropathy of the Arm

Abstract

The term canalicular neuropathy is applied to nerve lesions arising on nerve segments passing through the osteofibrous canals or other narrow orifices and resulting in nerve compression and entrapment. We studied 31 patients referred to us for non-traumatic canalicular syndromes in the upper limbs. After clinical, electrophysiological and morphological analysis of each case, we emphasize the role of MR imaging in establishing prognosis and selecting treatment. Anatomosurgical specimens correlated well with MR features, whereas there was little correlation between electrophysiological severity and anatomical changes. In summary, canalicular neuropathy is a clinical syndrome. The aim of MR investigation is to document the morphological changes which will serve to institute appropriate treatment. When patients have clinical and electrophysiological evidence of neuropathy without MR demonstration of the nerve lesion, therapy will be conservative, thus saving the cost and risk of surgery. On the other hand, when clinical and electrophysiological findings are flanked by MR demonstration of the neuropathy, the disease is known to be advanced and surgery will be indicated to prevent neurotmesis.