MR Neurography Findings of Soleal Sling Entrapment

Chhabra, Avneesh; Williams, Eric H.; Subhawong, Ty K.; Hashemi, Shar; Soldatos, Theodoros; Wang, Kenneth C.; Carrino, John A.

doi:10.2214/ajr.10.4925

Cited by 33 publications

(17 citation statements)

References 7 publications

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“…Excellent agreement between high-resolution 3T MRN images and intraoperative findings has been reported for tibial nerve entrapment at the soleal sling, where nerve conduction studies are difficult to perform owing to the depth at which the nerve is located 55 . Similarly, posterior tibial nerve entrapment at the tarsal tunnel, caused by a | Ultrasonography examination reveals a synovial cyst (dotted line) that is compressing and dislocating the ulnar nerve (arrows) in the Guyon canal in a 37-year-old man with acute sensory and motor impairment of the ulnar nerve and signs of axonal and demyelinating neuropathy in a nerve conduction study.…”

Section: Entrapment Neuropathiesmentioning

confidence: 75%

New technologies for the assessment of neuropathies

et al. 2017

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Peripheral neuropathies are among the most common neurological disorders 1 . In routine clinical practice, diagnosis of peripheral neuropathies is typically based on clinical assessment, nerve conduction studies and needle electromyography, which can determine whether symptoms are caused by primary axonal damage or demyelinating damage. This distinction is often relevant to therapeutic choices and to prognosis, as axonal damage typically reflects an inflammatory (for example, vasculitic) or degenerative (for example, hereditary or idiopathic) process that correlates with disability, whereas demyelinating damage can reflect a hereditary neuro pathy, but more often reflects an acquired immunemediated neuropathy. Besides metabolic, inflammatory or primary degenerative neuropathies, peripheral nerves can also be damaged by compression from adjacent tissue structures, such as tendons, cysts or haematomas. In this case, proper identification of the site, nature and degree of the lesion might be challenging, but is relevant to treatment and prognosis. Moreover, some patients present with symptoms that suggest damage to small nerve fibres, which nerve conduction studies cannot be used to detect.In the past 15 years, several techniques have become available to investigate focal and diffuse peripheral neuropathies, and their reliability has widened the spectrum of diagnostic tools for clinicians and improved assessment of neuropathies. In this Review, we provide an overview of these new and emerging technologies. We first discuss peripheral nerve imaging with MRI and ultrasonography, which can provide information about the precise localization of neuro pathies and the pathological processes involved in large-fibre neuropathies, and can complement clinical and electrophysiological evaluation. We then consider techniques that can provide diagnostic information when the pathological process is restricted to small nerve fibres and is consequently not detectable with nerve conduction studies or neuroimaging. These include skin biopsy, which is established in clinical practice, and the emerging techniques of corneal confocal microscopy, laser-evoked potentials and heat-related and pain-related evoked potentials, and microneurography.Nerve imaging technology Advances in imaging techniques have made it possible to gain great insight into nerve pathology with magnetic resonance and ultrasound. Each approach offers distinct advantages, and can provide different information about damage to large myelinated fibres. Abstract | Technical advances are rapidly changing the clinical and instrumental approach to peripheral nerve diseases. Magnetic resonance neurography, diffusion tensor imaging and nerve ultrasonography are increasingly entering the diagnostic workup of peripheral neuropathies as tools that complement neurophysiology and enable investigation of proximal structures, such as plexuses and roots. Progress in the design of magnetic resonance scanners and sequences, and the development of high-frequency ultrasound probes mean th...

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Section: Entrapment Neuropathiesmentioning

confidence: 75%

New technologies for the assessment of neuropathies

et al. 2017

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“…Several case reports have been published [1,10] on syndromes caused by compression of the TN by the SA [3,7]. Williams et al published a retrospective report on the surgical release of the proximal TN in 49 cases, 39 of whom with an atraumatic history including ten with proven neuropathy [11].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have suggested the use of magnetic resonance imaging (MRI) [6][7][8], which can visualize focal nerve-impairment by neural swelling and muscular denervation oedema. Its rather low resolution, predefined examination region and geometry,…”

Section: Introductionmentioning

confidence: 99%

A rare case of an acute soleus arcade syndrome complicated by a ganglion cyst: diagnosis by dynamic ultrasound

et al. 2017

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The soleus arcade syndrome is a rare compression neuropathy of the tibial nerve that often remains undiagnosed due to low clinical awareness and difficult diagnosis. We present the case of a female patient admitted with acute worsening of a pre-existing sensory tibial neuropathy and acute tibial nerve palsy after knee joint injection. After a knee magnetic resonance imaging remained non-diagnostic, dynamic ultrasonography was performed. Constriction by the soleus arcade and proximal swelling of the tibial nerve could be demonstrated during plantarflexion of the ankle by means of a dynamic examination in the standing patient. The patient underwent surgery and recovered fully. This proposed diagnostic approach can be used to identify soleus arcade syndrome by ultrasound.

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“…The Recent advances in nerve MR imaging (ie, neurography) include isotropic three-dimensional image acquisition and diffusion-weighted imaging (8)(9)(10), which have permitted improved visualization of small nerves, greater sensitivity to changes in nerve signal, and better delineation of the perineural soft tissues. The use of MR neurography in a wide range of anatomic locations has been described; these locations include the brachial plexus (11)(12)(13)(14), lumbosacral plexus (15)(16)(17), and sites along the upper (6,18,19) and lower (7,16,(20)(21)(22) extremities. Furthermore, surgical techniques for the repair of peripheral nerve injury have improved (23), and the use of postsurgical nerve imaging has been reported (24).…”

Section: Ontologiesmentioning

confidence: 99%