High-Resolution Ultrasound of Small Clinically Relevant Nerves Running Across the Posterior Triangle of the Neck

Picasso, Riccardo; Pistoia, Federico; Perez, Maribel Miguel; Klauser, Andrea; Rossi, Federica; Schenone, Angelo; Tagliafico, Alberto; Martinoli, Carlo

doi:10.1055/s-0040-1710067

Cited by 9 publications

(6 citation statements)

References 71 publications

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“…Sonography is another tool used to study the SCN, but this is more often used by anesthetists for shoulder regional anesthesia than by radiologists for the diagnosis of SCN lesions 19‐21 …”

Section: Discussionmentioning

confidence: 99%

The supraclavicular nerve

Séror

2022

Muscle and Nerve

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Introduction/Aims: The aim of this study was to describe a new method for studying the supraclavicular nerve (SCN) conduction and to report four cases with SCN lesions. Methods:The SCN was antidromically recorded with a pair of self-adhesive electrodes located in the middle of the clavicle. Stimulation (<5 mA) was delivered 7 cm proximally with a bar electrode. To facilitate recording, it was explained to the participant that they would feel a very faint electrical sensation locally and an electrical tingle upward (ear) or downward (shoulder/clavicle). Each participant was asked to say when the tingling moved downward.Results: In normal subjects, median values were 16 μV (range: 9-33) for sensory nerve action potential (SNAP) amplitude; 1.2 ms (range: 1-1.5) for onset latency; and 1.25 (range: 1-1.7) for side-to-side amplitude ratio. In the four patients, the SCN SNAP was absent on the pathological side and normal on the healthy side. All four patients complained of unilateral neuropathic hypoesthesia on the anterior aspect of the neck, chest, and shoulder that occurred after radical neck surgery for thyroid or larynx cancer (x3) and first rib resection (x1).Discussion: A comparison with previous reports shows that this simple method provides similar or highest SNAP amplitudes. SCN lesions are rare, and rarely referred for electrodiagnosis, and often overlooked. However, the SCN conduction study, which causes very slight inconvenience (low-intensity stimulation), allows a better understanding of the origin of the complaints and permits the patient to benefit of more suitable treatment.

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Section: Discussionmentioning

confidence: 99%

The supraclavicular nerve

Séror

2022

Muscle and Nerve

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“…In long-axis planes, nerves appear as elongated structures with alternating hypo-and hyperechoic bands. The development of ultrahigh frequency probes (up to 30 MHz) has provided new perspectives in the evaluation of sub-millimetric terminal nerve branches, visualized as single small hypoechoic dots within a hyperechoic frame lacking the expected classic "honeycomb" appearance [254][255][256][257][258][259][260][261].…”

Section: Nervesmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

et al. 2021

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The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice.

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“…Due to a higher spatial resolution, US is able to provide more precise information than MR imaging regarding the severity of nerve involvement and can better guide the hand surgeon to the appropriate operative strategy. 49,50 Using very high frequencies and last-generation technology, US is able to distinguish between partial and complete nerve tears, even when the injury affects submillimeter branches, and it may provide an accurate measurement of the gap intervening between the nerve ends in case of neurotmesis 51 (►Fig. 18).…”

Section: Small Hand Nervesmentioning

confidence: 99%

Hand and Wrist Neuropathies: High-resolution Ultrasonography and MR Neurography

Chhabra

Ratakonda

Picasso

et al. 2021

Semin Musculoskelet Radiol

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High-resolution ultrasonography (US) and magnetic resonance neurography (MRN) have followed parallel paths for peripheral nerve imaging with little comparison of the two modalities. They seem equally effective to study a variety of neuropathies affecting large and small nerves in the wrist and hand. This article outlines the technical considerations of US and MRN and discusses normal and abnormal imaging appearances of hand and wrist nerves from etiologies such as entrapment, injury, tumor, and proximal and diffuse neuropathy, with specific case illustrations.

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High-Resolution Ultrasound of Small Clinically Relevant Nerves Running Across the Posterior Triangle of the Neck

Cited by 9 publications

References 71 publications

The supraclavicular nerve

The supraclavicular nerve

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

Hand and Wrist Neuropathies: High-resolution Ultrasonography and MR Neurography

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