What is the role of ultrasonography in the evaluation of traumatic peripheral nerve injuries in the diagnosis of ulnar neuropathy?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

An area in which ultrasonography may be particularly useful is evaluation of traumatic peripheral nerve injuries. In one study, 20 fresh cadaver arms were disarticulated, and the median, ulnar, or radial nerves were randomly transected in zero, one, or two locations per arm. [120] Sham incisions were performed throughout the extremity. The peripheral nerves were then systematically scanned by ultrasonographers who were blinded to the sites of transection.

The investigators found that high-resolution ultrasonography was able to identify transected nerves with 89% sensitivity and 95% specificity. [120] The diagnostic accuracy improved throughout the study: With the first 10 arms, the ultrasonographer correctly identified the transection in 77% of cases, whereas with the final 10 arms, the accuracy was 100%.

These findings suggest that the experience of the ultrasonographer has a vital effect on the diagnostic utility of ultrasonography in peripheral nerve injury. Thus, ultrasonography may be useful in determining the prognosis for nerve injury when an experienced ultrasonographer is available to distinguish between partial and complete injury, in localizing a nerve transection for possible surgical repair, or in both. [120, 121]


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