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ORIGINAL RESEARCHObjectives-Occipital neuralgia is a headache that may result from greater occipital nerve entrapment. Entrapped peripheral nerves typically have an increase in crosssectional area. The purpose of this study was to measure the cross-sectional area and circumference of symptomatic and asymptomatic greater occipital nerves in patients with unilateral occipital neuralgia and to correlate the greater occipital nerve cross-sectional area with headache severity, sex, and body mass index.Methods-Both symptomatic and contralateral asymptomatic greater occipital nerve cross-sectional areas and circumferences were measured by a single examiner using sonography in 17 patients. The Wilcoxon signed rank test and Spearman rank order correlation coefficient were used to analyze the data.Results-Significant differences between the cross-sectional areas and circumferences of the symptomatic and asymptomatic greater occipital nerves were noted (P < .001). No difference existed in cross-sectional area (P = .40) or circumference (P = .10) measurements of the nerves between male and female patients. A significant correlation existed between the body mass index and symptomatic (r = 0.424; P = .045) and asymptomatic (r = 0.443; P = .037) cross-sectional areas. There was no correlation shown between the cross-sectional area of the symptomatic nerve and the severity of Headache Impact Test 6 scores (r = -0.342; P = .179).Conclusions-We report sonographic evidence showing an increased cross-sectional area and circumference of the symptomatic greater occipital nerve in patients with unilateral occipital neuralgia.
The majority of lumbar multifidus and abdominal muscle size measurements in firefighters are similar to the general population and soldiers. The larger lumbar multifidus CSA in firefighters compared with the general population warrants further study. These data provide a basis for future research using ultrasonography to assess muscle size in firefighters and other workers in physically-demanding occupations.
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