WS7.4. NMUS of the brachial plexus

Abstract

The brachial plexus can be involved in a variety of neuromuscular disorders, such as inflammatory and hereditary demyelinating neuropathies, neurofibromatosis, traumatic injuries, neoplasms, nerve sheath tumors. Traditionally, the evaluation of brachial plexus involvement has relied on combination of clinical features, electrodiagnostic testing and MRI imaging. Nerve imaging is an important and powerful add-on strategy, that can help to localize site of lesion and uncover nature and extend of nerve involvement. The apparent lack of clear association between nerve morphology and function further supports complementary role of imaging modalities in routine diagnostic work-up of peripheral nerve disorders. Although MRI has dedicated sequences that allow refined tissue discrimination, lack of objective cut-off values hamper it’s used in the routine clinical setting. Nerve ultrasound is an emerging practical bedside alternative to MRI, which the advantage of flexible field of view, superior image resolution for superficial structures, broad availability and relatively low cost. This neuromuscular ultrasound workshop will focus on main anatomical targets for sonographic evaluation of brachial plexus, including important landmarks and notes for discrimination. The workshop will also address standardized assessment and reference values for abnormality, including sonographic examples of neuromuscular disorders.