Original ContributionsUltrasound of radial, ulnar, median, and sciatic nerves in healthy subjects and patients with hereditary motor and sensory neuropathies
Introduction
The neurophysiological investigation of peripheral nerves is a domain of electroneuro- and electromyography. However, these methods only reflect the function, but not the anatomy, of nerves. Several studies indicate that both ultrasonography Fornage 1988, Fornage 1993, Graif et al 1991, Silvestri et al 1995, Buchberger et al 1993 and magnetic resonance imaging (Buchberger et al. 1993) can depict extremity nerves. Ultrasonography is easily available and inexpensive and, therefore, might be a suitable method for depicting nerves.
The present study was conducted to investigate the capability of ultrasonography to visualize extremity nerves and to describe their ultrasonographic structure and size at defined locations in 50 healthy subjects and in a group of 10 patients with asymptomatic, mild or moderate hereditary motor and sensory neuropathy (HMSN) type 1.
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Subjects
Fifty volunteers (25 women, 25 men), members of the staff in the Departments of Neurology and Clinical Neurophysiology, University of Goettingen, students and neurological patients without neuromuscular diseases, from 17 to 83 y old (median age, 30 y), with a median body weight of 70 kg (range, 47 to 105 kg) and height of 1.725 m (range, 1.56 to 2.00 m), and 8 adult and 2 juvenile neurological patients, 4 to 62 y old (median age, 34 y), with an HMSN were included in the study. The diagnoses
Healthy subjects
All nerves were more echogenic (hyperechoic) than surrounding muscles and subcutaneous fat. Parallel internal echoes (fascicular structure) in longitudinal scans were similar to those of tendons. Nerves could be distinguished from tendons, due to their localization and by means of dynamic examination as described by Fornage (Fornage, 1993): active contraction of the muscle as well as passive movement of the tendon results in considerable displacement of the tendon and echogenic aponeuroses, but
Discussion
Several recent studies indicate that ultrasonography can depict extremity nerves. Up to now, the median, ulnar and radial nerves (Fornage 1993), retroperitoneal femoral nerve (Sener et al. 1991), peroneal nerve in the popliteal space (Nebelung et al. 1993) and sciatic nerve (Graif et al. 1991) were investigated in small series of healthy subjects. Reference values of nerve thickness have been reported for the femoral nerve at the groin (Sener et al. 1991), the ulnar nerve (Pils et al. 1991),
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