Quality and Patient Safety Articles-Needle EMG and the Risk of Pneumothorax

Needle EMG and the Risk of Pneumothorax

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This document discusses the risk of pneumothorax, a rare complication of needle electromyography (EMG), in patients undergoing muscle examination around the thorax. Needle EMG is often used for evaluating scapular winging, shoulder weakness, and neuromuscular causes of dyspnea. The muscles that may require needle examination include serratus anterior, rhomboids, paraspinals, and the diaphragm. Among these muscles, the serratus anterior poses the highest risk of pneumothorax due to its location over the thorax. <br /><br />The frequency of pneumothorax after needle EMG is approximately 0.1-0.2% for high-risk muscles, although there is limited data on this topic. In a large study, only seven cases of pneumothorax were reported out of 71,782 needle examinations. Symptoms of pneumothorax usually present immediately or within 24 hours after EMG, with pleuritic chest pain or shortness of breath. Most cases improve spontaneously with conservative management. <br /><br />While the serratus anterior carries the highest risk, there are smaller risks associated with needle examination of the diaphragm, trapezius, rhomboids, supraspinatus, infraspinatus, and paraspinals. The use of ultrasound-guided needle placement may be beneficial for diaphragmatic EMG. Patients undergoing EMG should be informed of the potential risk of pneumothorax, and they should be aware of the symptoms to watch for after the procedure. <br /><br />The sources referenced in this document include studies that have explored the risks and complications of nerve conduction studies and needle EMG. However, specific details from these studies are not provided in the document. The authors of this document are Charles D. Kassardjian, Jayashri Srinivasan, and Nida G. Gleveckas-Martens.

Keywords

pneumothorax

needle electromyography

muscle examination

thorax

serratus anterior

diaphragm

risk

symptoms

conservative management

ultrasound-guided needle placement