Acute radial nerve entrapment at the spiral groove: detection by DTI-based neurography

Jengojan, Suren; Kovar, Florian M.; Breitenseher, Julia; Weber, Michael; Prayer, Daniela; Kasprian, Gregor

doi:10.1007/s00330-014-3562-6

Cited by 33 publications

(28 citation statements)

References 15 publications

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“…Prior investigative work has focused on the diagnostic accuracy of MR for peripheral nerve imaging [5,7,10,[17][18][19][20][21][22]. Previous impact studies in this domain are limited to a retrospective review looking at upper extremity nerve (median, radial, ulnar) abnormalities.…”

Section: Discussionmentioning

confidence: 98%

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

et al. 2015

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Section: Discussionmentioning

confidence: 98%

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

et al. 2015

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“…Im Allgemeinen erfolgt die MR-Neurographie T2-oder diffusionsbasiert. Dabeiermöglichtdie diffusionsbasierte MRNeurographie und hier insbesondere die Diffusionstensorbildgebung (DTI) auch funktionelle Aspekte von Nervenläsio-nen zu erfassen [13,22].…”

Section: Technik Der Mr-neurographieunclassified

Bildgebung des Plexus lumbosacralis

et al. 2017

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“…Because MRIs and clinical presentation are non-invasive techniques, we believe that the addition of compartment pressure evaluation is obligatory before a definitive diagnosis is made and a fasciotomy pursued. Although there has been evidence of variance in normal compartment values, any significant rise in pressure post-exercise is highly indicative of CECS [2, 3, 6, 12, 15, 17, 19]. In fact, many other studies have concluded that the best method for diagnosing CECS is evaluation of intracompartmental pressures (ICPs) before and after exercise [2, 5, 12, 15, 17, 20].…”

Section: Discussionmentioning

confidence: 99%

“…Borderline pressures are from 16–24 mmHg, while values above 25 mmHg are consistent with the diagnosis of CECS. Even though these values are based on the much more common presentation of CECS in the lower limb, they are used in most studies of CECS in the upper extremity [2, 3, 15–17, 19]. Due to the rarity of upper extremity cases, Ardolino et al attempted to experimentally determine normal, asymptomatic, forearm pressures before and after exercise [12].…”

Section: Discussionmentioning

confidence: 99%

Chronic Exertional Compartment Syndrome in the Forearm of a Collegiate Softball Pitcher

et al. 2017

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BackgroundChronic exertional compartment syndrome (CECS) is a recognized condition in the lower limb, with many reports in the literature. However, very few instances include CECS of the upper limb. This article presents the case of a collegiate softball pitcher presenting with CECS in her right forearm. To our knowledge, this is the first case report of a softball player with CECS, with only one similar incident in a major league baseball player.PurposeThe rarity of this condition normally places it low on the differential diagnosis. However, we hope that the presentation of this case and the review of the literature will aid in making swift and accurate diagnoses of CECS in future patients. We discuss the importance of three specific modalities in the diagnosis of this patient, what diagnostic criteria proved less conclusive, and the paradoxical course the syndrome presented with.Study DesignCase ReviewResultsOver a six-month period, the patient presented with peculiar presentations and exam results. A broad list of differential diagnoses had to be narrowed down through the presence or absence of relevant findings. These included cessation of exercise for 1 month, physical therapy, anti-inflammatory medicines, an electromyography/electromyogram (EMG), nerve conduction study (NCS), non-exercise magnetic resonance imaging (MRI) of the forearm, cervical MRI, and cervical computed tomography (CT) angiogram. After the above interventions were attempted and the relative findings of three important modalities were summarized, a fasciotomy and release of the dorsal, volar, and mobile wad compartments was performed. The patient’s symptoms were relieved, and she eventually returned to full play in softball at the university.ConclusionsThe three diagnostic criteria we believed to be most helpful in this case, and for future cases of CECS in the forearm, include the clinical presentation, pre- and post-exercise MRI, and pre- and post-exercise compartment pressure measurements.Clinical RelevanceChronic exertional compartment syndrome of the forearm is extremely rare, especially in the female athlete. This case report and review of the literature may be helpful to the clinician facing similar cases. It describes which clinical tests are most helpful for diagnosis and which findings may be distracting.

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Acute radial nerve entrapment at the spiral groove: detection by DTI-based neurography

Abstract: • DTI-based neurography detects nerve changes during acute nerve compression. • Compression leads to a transient increase in local radial nerve FA values. • DTI provides insights into radial nerve vulnerability at the spiral groove.

Cited by 33 publications

References 15 publications

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

Bildgebung des Plexus lumbosacralis

Chronic Exertional Compartment Syndrome in the Forearm of a Collegiate Softball Pitcher

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