Neuromuscular Ultrasound in Correlation to Neurophysiological Findings
Summary
1. Study the neuromuscular ultrasound findings in different types of neuropathies
2. correlation between ultrasound and neurophysiological findings in peripheral nerve diseases
3. correlation between clinical pain scale and severity of neuropathy
Description
Ultrasonography is a diagnostic tool that is increasingly used in the work-up of peripheral nerve disease.
As many peripheral nerves run a superficial course, especially in the arms. This is a big advantage over Magnetic Resonance Imaging that is relatively expensive, time consuming and not readily available everywhere.
Nerve cross-sectional area (CSA) can be determined at multiple sites along the nerve.
CSA can be measured at entrapment sites but also at nonentrapment sites. vascularization, echogenicity, fascicular pattern and endoneurial thickness can be investigated as well. All those modalities can give critical insight in the origin and development of various peripheral neuropathies1,2,3
Major peripheral nerves in the extremities, such as the median,ulnar thick enough to reflect the sound beam, resulting in hyperechoic on the US scan 4.
The correlation between nerve conduction study parameters and CSA in ultrasound Ultrasound of the peripheral nervous system is an additional useful diagnostic tool in neuromuscular disorders..5,6,7,8,9 In the longitudinal plane, nerves present as long, slim structures with a mixture of parallel hypoechoic and hyperechoic lines.
Nerves must be distinguished from other nearby structures to ensure correct identification Muscles are hypoechoic and interspersed with small hyperechoic foci which easily distinguishes muscles from nerves. Tendons, which are sometimes adjacent to nerves, move proportionately with joint movement.
US has higher specificity than sensitivity in differentiating myopathic and neuropathic changes The most sensitive diagnostic marker for symptomatic carpal tunnel syndrome patients is an enlarged crosssectional area of the median nerve 10,11,12
Study Design
Conditions
Carpal Tunnel Syndrome
Intervention
ultrasound
Status
Not yet recruiting
Source
Assiut University
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT04092140
- ClinicalTrials.gov processed this data on September 20, 2019
Published on BioPortfolio: 2019-09-23T04:51:49-0400
Clinical Trials
The Use of Ultrasound to Quantify Muscle Overlying the Carpal Tunnel
Carpal tunnel syndrome (CTS) is a common condition that still lacks a reliable, objective screening test. Many anatomical aspects of the syndrome have been studied including the dimensions...
Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with involving compression of the median nerve in the carpal tunnel. The technique of perineural injection ...
Percutaneous Treatment of Carpal Tunnel Syndrome With Scan
The objective of the study is to evaluate in patients suffering from carpal tunnel syndrome resistant to medical treatment, clinical course after percutaneous treatment under ultrasound gu...
Corticosteroid Injection in Carpal Tunnel Syndrome
To compare the effectiveness of different dose of ultrasound guided steroid injection in patient with carpal tunnel syndrome, by using clinical and electrophysiological parameters in evlau...
An innovative diagnostic ultrasound method for carpal tunnel syndrome was proposed and compared between carpal tunnel syndrome patients and healthy volunteers.
PubMed Articles
Value of cross-sectional area of median nerve by MRI in carpal tunnel syndrome.
Carpal tunnel syndrome is diagnosed based on history, physical examination, and nerve conduction testing; however, there are no clear criteria for the diagnosis of carpal tunnel syndrome. Recently, st...
Endoscopic Carpal Tunnel Release Via a Monoportal Approach.
Carpal tunnel syndrome is a very common condition in hand surgery. The gold standard in therapy is the surgical release of the flexor retinaculum. Endoscopic carpal tunnel release provides superior co...
To systematically review and evaluate the efficacy and complication profile of platelet-rich plasma (PRP) injection into the carpal tunnel for management of carpal tunnel syndrome (CTS).
In hand surgery, and specifically carpal tunnel syndrome, it is currently unknown whether experiences with health care influence surgical outcome. To investigate whether there is an association betwee...
Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy in humans. Nonsurgical management is still a matter of debate, and conservative treatments include splinting, local steroid inje...
Medical and Biotech [MESH] Definitions
Carpal Tunnel Syndrome
Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45)
Median Neuropathy
Disease involving the median nerve, from its origin at the BRACHIAL PLEXUS to its termination in the hand. Clinical features include weakness of wrist and finger flexion, forearm pronation, thenar abduction, and loss of sensation over the lateral palm, first three fingers, and radial half of the ring finger. Common sites of injury include the elbow, where the nerve passes through the two heads of the pronator teres muscle (pronator syndrome) and in the carpal tunnel (CARPAL TUNNEL SYNDROME).
Amyloid Neuropathies
Disorders of the peripheral nervous system associated with the deposition of AMYLOID in nerve tissue. Familial, primary (nonfamilial), and secondary forms have been described. Some familial subtypes demonstrate an autosomal dominant pattern of inheritance. Clinical manifestations include sensory loss, mild weakness, autonomic dysfunction, and CARPAL TUNNEL SYNDROME. (Adams et al., Principles of Neurology, 6th ed, p1349)
Carpal Joints
The articulations between the various CARPAL BONES. This does not include the WRIST JOINT which consists of the articulations between the RADIUS; ULNA; and proximal CARPAL BONES.
Cubital Tunnel Syndrome
Compression of the ULNAR NERVE in the cubital tunnel, which is formed by the two heads of the flexor carpi ulnaris muscle, humeral-ulnar aponeurosis, and medial ligaments of the elbow. This condition may follow trauma or occur in association with processes which produce nerve enlargement or narrowing of the canal. Manifestations include elbow pain and PARESTHESIA radiating distally, weakness of ulnar innervated intrinsic hand muscles, and loss of sensation over the hypothenar region, fifth finger, and ulnar aspect of the ring finger. (Joynt, Clinical Neurology, 1995, Ch51, p43)
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