Prospective clinical and sonographic observation of the patient with hourglass-like focal radial nerve constriction

Abstract

This prospective clinical and sonographic observation of the 29 y.o. woman with acute neuropathic pain along the course of the radial nerve, who was later diagnosed with hourglass-like focal radial nerve constriction at the level of the inner fold of the elbow. Dynamic observation was carried out at the level of the most severe pain (at the inner fold of the elbow), starting from the 3rd day after onset of symptoms and within 15 months. At the time of patient’s admission pain syndrome and paresis of extensor muscles of the hand and fingers were significantly pronounced, but we didn’t detect any sonographic changes of the radial nerve. During dynamic observation the segment of focal peripheral nerve constriction has been detected on the 30th day of observation and the portion of multisegmental constriction on the 57th day of observation, but the observed changes did not correlate with the rate of neurologic deficit restoration. On the scans of the radial nerve obtained 9 and 15 months after disease onset the uniform decrease in the nerve diameter was evident, which made it impossible to visualize focal peripheral nerve constriction.