Seminars in musculoskeletal radiology
-
Semin Musculoskelet Radiol · Nov 2010
ReviewPeripheral nerves: ultrasound-guided interventional procedures.
Specific ultrasound (US)-guided interventional procedures on peripheral nerves are reviewed in this article including regional anesthesia, biopsy of neural lesions, and some injection therapies. For these procedures, US is the best modality to provide a safe imaging guidance because of its excellent spatial resolution and real-time capabilities. ⋯ The use of US-guided injections in specific clinical settings, such as the percutaneous treatment of carpal tunnel syndrome, Morton's and saphenous neuromas, painful stump neuromas, piriformis syndrome, and meralgia paresthetica are also illustrated here. US allows the clinician to inject drugs with little or no patient discomfort.
-
Semin Musculoskelet Radiol · Nov 2010
ReviewUltrasound and magnetic resonance imaging of the peripheral nerves: current techniques, promising directions, and open issues.
High-resolution ultrasound (US) and magnetic resonance (MR) imaging are the two imaging methods of choice for the study of peripheral nerves. The many advances that have been made in recent years, either by US or MR imaging, including diffusion tensor imaging and tractography, offer new perspectives for the assessment of many pathological processes affecting peripheral nerves such as entrapment syndromes, tumors and tumor-like lesions, and traumatic disorders. ⋯ US and MR imaging are complementary, each having advantages and disadvantages. Tractography is still emerging in the musculoskeletal field, particularly for the analysis of peripheral nerves, but this technique seems promising.
-
Semin Musculoskelet Radiol · Nov 2010
ReviewEntrapment neuropathies I: upper limb (carpal tunnel excluded).
Several entrapment neuropathies of the upper extremity can cause hypoechoic swelling and nerve compression as seen at ultrasound. The ulnar nerve can be compressed at the cubital tunnel of the elbow and Guyon's canal at the wrist. ⋯ In addition to compression at the carpal tunnel, the median nerve may be compressed at the elbow, related to a supracondylar process or by the pronator teres. Knowledge of these key anatomical sites of potential nerve compression is essential for accurate diagnosis of entrapment neuropathies.
-
Clinicians frequently encounter compressive neuropathies of the lower extremity. The clinical history and physical examination, along with electrodiagnostic testing and imaging studies, lead to the correct diagnosis. ⋯ We provide a detailed review of compression neuropathies of the lower extremity with an emphasis on magnetic resonance (MR) imaging characteristics. We discuss the clinical presentation, etiology, anatomical location, and MR imaging appearance of these neuropathies, including the piriformis syndrome, iliacus syndrome, saphenous neuropathy, obturator neuropathy, lateral femoral cutaneous neuropathy (meralgia paresthetica), proximal tibial neuropathy, common peroneal neuropathy, deep peroneal neuropathy, superficial peroneal neuropathy, tarsal tunnel syndrome, Baxter's neuropathy, jogger's foot, sural neuropathy, and Morton's neuroma.