2023 Workshop Handout Bundle-Basic NM US (Dr. Baute Penry)

Basic NM US (Dr. Baute Penry)
Pdf Summary
Neuromuscular ultrasound is a painless, noninvasive, and informative technology for diagnosing and evaluating patients with suspected neuromuscular diseases. It complements electrodiagnostic studies by providing detailed anatomical information about nerves, muscles, tendons, and other structures that cannot be obtained with nerve conduction studies and electromyography. The technique has been extensively studied in the assessment of entrapment neuropathies, such as carpal tunnel syndrome, ulnar neuropathy at the elbow and wrist, and fibular neuropathy at the knee. The typical findings in these conditions include nerve enlargement just proximal to the site of entrapment, changes in nerve echotexture, shape, fascicle size, and vascularity. However, nerve flattening or pinching is not a common finding. In addition, structures near the nerve, such as cysts, tumors, and aberrant muscles, should be assessed to determine if there are anatomical explanations for the entrapment. Neuromuscular ultrasound is also useful in identifying anatomic abnormalities that could mimic or contribute to entrapments, such as ganglion cysts, lipofibromatous hamartomas, and thrombosed arteries. There are no specific reference values for nerve cross-sectional areas in entrapment neuropathies, but certain cutoffs have been proposed to define nerve enlargement. Overall, neuromuscular ultrasound is a valuable tool in diagnosing and evaluating entrapment neuropathies and can improve treatment strategies.