The role of fluid-sensitive MRI in early diagnosis of post-COVID-19 unusual motor neuropathies

Abstract

Post-COVID-19 motor neuropathies frequently result atypical for location and contemporary involvement of different nervous districts. These aspects often complicate the electromyography (EMG) diagnosis. Inducing severe and atypical forms of disability, motor mononeuropathies early recognition is of primary importance for a specific rehabilitation treatment. Several evidence supported magnetic resonance (MRI) as a useful tool in the early diagnosis of muscle denervation. We describe the case of a 57-year-old male patient with a severe post-COVID-19 motor deficit in the proximal region of left upper limb, with a significant limitation in left shoulder abduction. MRI, required in suspected tendinopathy, showed a high hyperintensity signal in the “fluid sensitive” sequences of both supraspinatus and infraspinatus muscles, suggesting denervation of these muscle districts in a selective, severe injury of the left suprascapular nerve. This diagnostic hypothesis was subsequently confirmed by EMG. This clinical case confirms that MRI could represents a valuable supplementary resource in unusual post-COVID-19 motor neuropathies diagnosis, allowing an early and specific rehabilitation.