Monograph: Sports-related peripheral nerve injuries of the upper limb
Abstract
Peripheral nerve injuries in athletes affect the upper limb more commonly than the lower limb. Common mechanisms include compression, traction, laceration, and ischemia. Specific sports can have unique mechanisms of injury and are more likely to be associated with certain neuropathies. Familiarity with these sport-specific variables and recognition of the common presentations of upper limb neuropathic syndromes are important in assessing an athlete with a suspected peripheral nerve injury. Evaluation may require imaging modalities and/or electrodiagnostic testing to confirm a nerve injury. In some cases, diagnostic injections may be needed to differentiate neuropathic versus musculoskeletal etiology. Early and accurate diagnosis is essential for treatment/management and increases the likelihood of safe return-to-sport and avoidance of long term functional consequences. Most nerve injuries can be treated conservatively, however severe or persistent cases may require surgical intervention. This monograph reviews key diagnostic, management, and preventative strategies for sports-related peripheral nerve injuries involving the upper limb.
Objectives: The objectives of this activity are to: 1)Be able to evaluate and manage patients with brachial plexopathy; 2) Be able to evaluate and manage patients with mononeuropathes of the shoulder and arm, including suprascapular, axillary, musculocutaneous, and long thoracic neuropathies. 3) Be able to evaluate and manage patients with neuropathies of the elbow, forearm and hand including radial, ulnar, and median neuropathies.
ACCREDITATION STATEMENTThe AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
DISCLOSURE INFORMATION
None of the authors has any conflict of interest to disclose.
CREDIT DESIGNATION The AANEM is accredited by the American Council for Continuing Medical Education (ACCME) to providing continuing education for physicians. AANEM designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Rebecca Dutton MD; John Norbury MD; Berdale Colorado MD