Importance of Anatomic Peculiarities and Ultrasound-Guided Electromyography of the Extensor Indicis Proprius Muscle

Abstract

The extensor indicis proprius muscle (EIPM) is considered a key muscle in the assessment of the level of the neurologic lesion causing any motor or sensory medio-cubital impairment of the hand. The aim of this study is to illustrate the anatomical peculiarities of the EIPM, the ultrasound (US) anatomy of the inferoposterior part of the forearm, and the technique of US-guided electromyography (EMG) of the EIPM. The US-guided EMG of the EIPM is technically easy and safe for young practitioners, provided there is a good knowledge of US anatomy of the inferoposterior part of the forearm.

The value of ultrasound-guidance of nerves and muscles for patient tolerance and parameters electrodiagnostic studies

“…The most commonly chosen muscles were the psoas and teres pronator muscles (40 versus 1 and 21 versus 13, respectively), the other muscles were too infrequently punctured to identify a difference between the two groups. USG muscle has been used to facilitate muscle biopsies increase the accuracy of standard needle electromyography (EMG) for non-routine muscles such as the extensor indicis muscle and tibialis posterior, for plegic muscles, for junior resident physicians or scanning EMG ( Billakota et al, 2016 , Connell et al, 2023 , Elleuch et al, 2021a , Elleuch et al, 2021b , Gentile et al, 2020 , Karvelas et al, 2016 , Maitland et al, 2022 , Padua et al, 2023 ). In the study on residents, needle electrode placement accuracy improved with residency years.…”

Flexor Carpi Radialis Muscle: Anatomic Features and Electromyography Technique Under Ultrasound Control

“…It is currently accepted that US guidance is a complementary tool for EMG [5,6]. Several studies have also shown that US is essential for performing EMG of small and deep muscles [2,7,8]. For example, the study by Jin TG et al showed that the accuracy of EMG needle placement for the extensor indicis proprius and the supinator muscle was very low without US control.…”

“…The use of US requires expertise, particularly for deep, thin or pathological muscles that are considered key in diagnosing the neural damage level [1,2]. For example, the flexor carpi radialis muscle (FCRM) is considered a key muscle in diagnosing the neurological lesion causing upper limb extensors' deficiency [3].…”