Self-Assessment: Challenging Imaging Cases | NMUS in Children-Session recording- NMUS in Children

Video Transcription

Video Summary

This presentation focuses on the use of neuromuscular ultrasound in pediatric patients, highlighting its advantages, techniques, and clinical applications in muscle and nerve imaging. Ultrasound offers superior resolution especially in children due to superficial anatomy, is painless, radiation-free, portable, and cost-effective compared to MRI or CT, which may require sedation and are more expensive. Dr. Verma emphasized ultrasound’s utility in assessing muscle diseases such as congenital muscular dystrophies (e.g., collagen VI-related), Duchenne muscular dystrophy, and inflammatory myopathies by evaluating muscle thickness, echo intensity via the Heckmatt scale, and muscle architecture. Ultrasound also aids in screening newborns with motor delays or newborn screening abnormalities (e.g., SMA, Pompe disease), guiding muscle biopsy site selection, and differentiating patterns of homogeneous or inhomogeneous muscle involvement. Limitations include operator dependence and the need for anatomical expertise.<br /><br />Dr. Cartwright discussed nerve ultrasound, underscoring the importance of reference values that increase with growth, mainly driven by weight. Nerve ultrasound reduces the need for painful needle EMG in children and complements electrodiagnostic studies, allowing for early diagnosis and guiding treatment, as shown in clinical cases of inherited neuropathies, CIDP, and HNPP. The speakers emphasized performing ultrasound first in the diagnostic workflow to minimize invasive procedures. They reviewed billing codes for neuromuscular ultrasound, recommended proper machine setup and video documentation, and discussed future advances including AI integration and standardized scoring systems for inflammatory neuropathies. Overall, neuromuscular ultrasound is a rapidly evolving, valuable, non-invasive tool in pediatric neurology, improving diagnostic accuracy and patient experience.

Keywords

neuromuscular ultrasound

pediatric patients

muscle imaging

nerve imaging

muscular dystrophies

Duchenne muscular dystrophy

inflammatory myopathies

motor delay screening

newborn screening

nerve ultrasound

nerve ultrasound reference values

electrodiagnostic studies

inherited neuropathies

AI integration

AI integration in ultrasound