US Literature Review in Focal Peripheral Entrapment Neuropathies and Multifocal Motor Neuropathy-Dr. Kim - US Literature Review in Focal Peripheral Entrapment Neuropathies and Multifocal Motor Neuropathy

Dr. Kim - US Literature Review in Focal Peripheral Entrapment Neuropathies and Multifocal Motor Neuropathy

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This literature review explores the use of ultrasound (US) in the diagnosis and management of focal peripheral entrapment neuropathies, specifically focusing on conditions such as carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow (UNE), fibular neuropathy at the fibular head, and tibial neuropathy at the tarsal tunnel. <br /><br />The review highlights several key findings from various studies. In the investigation of common mononeuropathies, US was found to be contributory and confirmatory in diagnosing and assessing these conditions. It provided valuable morphological and dynamic real-time information, and its findings were often more accurate than electrodiagnostic studies (EDX). US parameters such as nerve cross-sectional area (CSA), swelling ratio, and CSA difference were found to have high diagnostic accuracy in diagnosing CTS and UNE. However, the use of US was limited in distinguishing between moderate and severe cases of CTS.<br /><br />In the diagnosis of CTS, US measurement of the median nerve CSA at the wrist was found to be accurate and may be offered as a diagnostic test. It was also discovered that US provided additional value by detecting structural abnormalities and aiding in the assessment of severity and prognosis. Similar findings were observed in the diagnosis of UNE, where US measurement of the ulnar nerve at the elbow was accurate and could help confirm the diagnosis and localize the site of compression. However, the accuracy of US was not sufficient to replace clinical examination or EDX.<br /><br />US was also useful in the diagnosis and management of fibular neuropathy at the fibular head and tibial neuropathy at the tarsal tunnel. The assessment of CSA, echogenicity, and nerve movement provided valuable insights for these conditions.<br /><br />Overall, the review emphasizes the value of incorporating US into routine clinical care for the diagnosis and management of focal peripheral entrapment neuropathies. US can provide additional information, improve diagnostic accuracy, and aid in treatment decision-making. However, further research and standardization of US parameters are still needed to enhance its utility and improve patient outcomes.

Keywords

ultrasound

diagnosis

management

focal peripheral entrapment neuropathies

carpal tunnel syndrome

ulnar neuropathy at the elbow

fibular neuropathy at the fibular head

tibial neuropathy at the tarsal tunnel

nerve cross-sectional area

swelling ratio

CTS

nmus

sono