2023 Workshop Handout Bundle-Advanced US of Lower Limb Nerves

Advanced US of Lower Limb Nerves

Pdf Summary

High-resolution ultrasound (US) serves as a valuable tool in diagnosing and managing conditions affecting peripheral nerves, such as entrapments, tumors, and trauma-related injuries. This advanced imaging technique provides excellent resolution and a dynamic field of view of peripheral nerves, although it faces limitations like difficulty imaging through bone and operator dependence.<br /><br />Training in neuromuscular ultrasound is especially beneficial for physicians with neuromuscular expertise, such as those experienced in electrodiagnostic examination. Combining ultrasound with traditional methods like nerve conduction studies (NCS) and needle electromyography (EMG) enhances diagnostic efficiency, identifying surgically amenable pathologies and impacting clinical approaches in a significant subset of patients.<br /><br />Ultrasound offers several advantages over MRI, including higher sensitivity for detecting nerve issues and the ability to better identify multifocal lesions. It's often the initial imaging choice for peripheral nerves unless studying deep or bone-covered nerves.<br /><br />Normal anatomy on US displays nerves with a “honeycomb” structure in short-axis and a “tram track” appearance in long-axis. Pathological changes such as breaks in connective tissue, loss of fascicular architecture, or swelling can be indicative of conditions like entrapments or tumors.<br /><br />For specific conditions like Carpal Tunnel Syndrome (CTS) and Ulnar Nerve Entrapment (UNE), US can localize nerve entrapments and guide surgical planning. It’s also valuable in diagnosing and managing other nerve pathologies such as peroneal mononeuropathy, intraneural ganglion cysts, and nerve sheath tumors.<br /><br />In cases of nerve trauma, US can detect nerve transections sooner than EDX, aiding in early surgical interventions. Furthermore, it assists in managing chronic issues by locating neuromas or scar tissue.<br /><br />Overall, integrating ultrasound with clinical and electrodiagnostic assessments significantly improves patient outcomes, providing a comprehensive approach to diagnosing and treating peripheral nerve diseases.

Keywords

high-resolution ultrasound

peripheral nerves

nerve entrapments

nerve tumors

nerve trauma

neuromuscular ultrasound

nerve conduction studies

ncs

electromyography

Carpal Tunnel Syndrome

CTS

Ulnar Nerve Entrapment

CTS

carpal tunnel syndrome

nerve conduction studies

nerve conduction study

ncs

EMG