Abstract
BackgroundHigh-resolution ultrasonography (US) is a non-invasive, readily applicable imaging modality capable of depicting real-time static and dynamic information concerning the peripheral nerves and their surrounding tissues. Although electrophysiological studies are the gold standard in the evaluation of nerve injuries, US can be used also to evaluate the morphological changes of nerve injuries.ObjectivesTo evaluate the role of the high-resolution US in the assessment of nerve injuries and to compare it to the role of electrodiagnostic studies.Subjects and methodsA total of 30 nerves from 22 consecutive patients with clinically definite nerve injury were considered. Two independent and blinded clinicians perform electrodiagnosis and US. The clinical, neurophysiological, and US findings were collected, and the contribution of US was then classified as “ contributive” or “non-contributive”, according to whether US confirmed the clinical and neurophysiological diagnosis or not.ResultsUS was “contributive” (confirming the electrophysiological diagnosis) in 66.67% of cases (n = 20), providing information about continuity of the nerve, morphological changes after injury as swelling, scar tissue formation, or neuroma formation with sensitivity of 75% compared to the electrodiagnostic studies and accuracy of 66.67%.ConclusionUltrasound can be used, when available, as a complementary tool for electrodiagnostic studies to provide anatomical information about the injured nerves in case of complete axonal lesion.
Highlights
Traumatic peripheral nerve injuries are common in clinical practice
While electrophysiological studies provide important diagnostic data in evaluating the relative location and degree of nerve dysfunction, they are limited in their ability to identify morphological changes associated with a particular type of nerve injury
We found a statistically significant difference between diagnosis of nerve injury done by Electrodiagnostic studies (EDX) and by highresolution US regarding continuity of the nerve (p = 0.05)
Summary
Traumatic peripheral nerve injuries are common in clinical practice. The type of peripheral nerve injury is a key factor for determining optimal treatment [1].Though clinical evaluation and electrophysiological studies remain a mainstay in the initial detection and diagnosis of peripheral nerve pathologies, US is playing complementary and growing roles in the overall clinicalElectrophysiology is still the clinical “gold standard” for nerve assessment, but rapidly accumulating literature exist comparing this modality with US. Traumatic peripheral nerve injuries are common in clinical practice. The type of peripheral nerve injury is a key factor for determining optimal treatment [1]. Electrophysiology is still the clinical “gold standard” for nerve assessment, but rapidly accumulating literature exist comparing this modality with US. While electrophysiological studies provide important diagnostic data in evaluating the relative location and degree of nerve dysfunction, they are limited in their ability to identify morphological changes associated with a particular type of nerve injury. US can reliably provide this information, and it does so in a painless manner, as compared to electrodiagnostic studies [3]. High-resolution ultrasonography (US) is a non-invasive, readily applicable imaging modality capable of depicting real-time static and dynamic information concerning the peripheral nerves and their surrounding tissues. Electrophysiological studies are the gold standard in the evaluation of nerve injuries, US can be used to evaluate the morphological changes of nerve injuries
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