Peripheral Neuropathies of the Median, Radial, and Ulnar Nerves: MR Imaging Features

Andreisek, Gustav; Crook, David; Burg, Doris; Marinček, Borut; Weishaupt, Dominik

doi:10.1148/rg.265055712

Cited by 279 publications

(246 citation statements)

References 69 publications

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“…A diagnosis is usually made by electromyography (EMG) or nerve conduction studies. However, MRI can be helpful to confirm the diagnosis and demonstrate any neural compressive lesions or anatomic variants that may help localize the site of compression (56)(57)(58). Edema may be seen within muscles supplied by the affected nerve within 24-48 hours after denervation.…”

Section: Neural Pathologymentioning

confidence: 99%

“…For this reason it is usually seen in professional cleaners, window cleaners, truck drivers, and weight lifters. There may be associated numbness and paresthesia in the median nerve distribution, but only rarely weakness of the muscles innervated by the nerve, particularly the flexor pollicis longus (58,62,76).…”

Section: Median Nervementioning

confidence: 99%

“…Individuals present with dull pain over the volar aspect of the forearm, but as the nerve is a motor branch, there is rarely any sensory defect. The predominant finding in anterior interosseous nerve syndrome is weakness of the flexor pollicis longus, flexor digitorum profundus tendons to the index and middle fingers, and pronator quadratus (58,62,76).…”

Section: Median Nervementioning

confidence: 99%

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Magnetic resonance imaging of the elbow

Stevens

2010

Magnetic Resonance Imaging

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Elbow pain is frequently encountered in clinical practice and can result in significant morbidity, particularly in athletes. Magnetic resonance imaging (MRI) is an excellent diagnostic imaging tool for the evaluation of soft tissue and osteochondral pathology around the elbow. Recent advances in magnetic field strength and coil design have lead to improved spatial resolution and superior soft tissue contrast, making it ideal for visualization of complex joint anatomy. This article describes the normal imaging appearances of anatomy around the elbow and reviews commonly occurring ligamentous, myotendinous, neural, and bursal pathology around the elbow.

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Section: Neural Pathologymentioning

confidence: 99%

Section: Median Nervementioning

confidence: 99%

Section: Median Nervementioning

confidence: 99%

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Magnetic resonance imaging of the elbow

Stevens

2010

Magnetic Resonance Imaging

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“…arpal tunnel syndrome (CTS) is the most common peripheral neuropathy of an upper extremity, and it is caused by an entrapment of the median nerve at the level of the carpal tunnel (1). The carpal tunnel is formed by the carpal bones, which form a concave arch, and the transverse carpal ligament, which lies on the arch.…”

mentioning

confidence: 99%

Diffusion tensor imaging in carpal tunnel syndrome

Taşdelen¹,

Gürses²,

Kılıçkesmez³

et al. 2011

Diagn Interv Radiol

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60C arpal tunnel syndrome (CTS) is the most common peripheral neuropathy of an upper extremity, and it is caused by an entrapment of the median nerve at the level of the carpal tunnel (1). The carpal tunnel is formed by the carpal bones, which form a concave arch, and the transverse carpal ligament, which lies on the arch. The ligament is also fused to the pisiform, the hook of the hamate at the ulnar side, the tubercle of the navicular bone, the crest of the trapezium, and the radial styloid (2).CTS is a common disorder with an estimated 8% annual incidence rate, and an accurate diagnosis can be achieved by considering the patient's electrodiagnostic features and symptom characteristics. Electrodiagnostic testing is considered the single most accurate method of diagnosis, but a high rate of false negatives and positives are also well documented. If electrodiagnostic findings are not available, then the patient's characteristic symptoms and physical examination may provide the best diagnostic information (3).Fat-saturated, T2-weighted magnetic resonance imaging (MRI) can reveal morphological changes in CTS patients, such as nerve enlargement, nerve flattening, increased nerve signal intensity, and bowing of the flexor retinaculum at the level of the hamate hook. However, the sensitivity and specificity of MRI findings are low; therefore, conventional MRI may provide insufficient diagnostic data for clinically assessing CTS (1).Diffusion tensor imaging (DTI) is an advanced MRI technique that is used to measure the diffusion of water in tissue (4). In white matter, water diffusion is anisotropic due to its impermeable boundaries, and this anisotropy can be measured with DTI; therefore, its main clinical application is white-matter tract visualization, but recently, it has been shown that DTI can be useful for imaging non-neural tissue, such as peripheral nerves (5-8), muscle (9), and prostate (10). There are a few preliminary reports in the literature on the application of DTI for diagnosis of CTS, but they include a limited number of subjects. Nevertheless, these reports found decreased fractional anisotropy (FA) and increased radial diffusivity at the median nerve within the carpal tunnel (8,11,12).Here, we investigated DTI's diagnostic utility in a large group of CTS patients using two quantitative measures: FA and the apparent diffusion coefficient (ADC). We also measured the correlation between CTS severity and FA. Materials and methods PatientsWe prospectively evaluated 57 wrists in 38 CTS patients (34 females and 4 males; mean age, 48 years; age range, 25-73 years; median age, MUSCULOSKELETAL IMAGING ORIGINAL ARTICLE Diffusion tensor imaging in carpal tunnel syndromeNeslihan Taşdelen, Bengi Gürses, Özgür Kılıçkesmez, Zeynep Fırat, Geysu Karlıkaya, Mustafa Tercan, Aziz Müfit Uluğ, Ahmet Nevzat Gürmen PURPOSEWe aimed to investigate the efficacy of diffusion tensor imaging in the diagnosis of carpal tunnel syndrome and to obtain a quantitative parameter that may contribute to the diagnosis. MATERIALS AND METH...

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“…Apertura del hiato superficial y profundo del canal de Guyon dinopatías, anomalías musculares, gangliones, quistes o tumores) (6,7) .…”

Section: Figuraunclassified

Lesiones del nervio cubital en el canal de Guyon: a propósito de 6 casos

Macías¹,

Castellano

Vélez

et al. 2009

Rev Iberoam Cir Mano

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(4) Médico asistencial de la UPS de FREMAP -Las Palmas músculos intrínsecos de inervación cubital, por lo que el conocimiento de la anatomía de esta región, permitirá hacer un diagnóstico clínico relativamente fácil y precisar cuál es el sitio de la compresión (1) .Al llegar a la mano, el nervio cubital se sitúa por dentro de la arteria, tras desprenderse de la cara profunda del tendón del flexor carpi ulnaris, contorneando el borde externo de este tendón, y pasando enseguida por fuera del pisiforme y por delante del ligamento anular anterior del carpo. Está delimitado hacia atrás (suelo) por el ligamento anular anterior del carpo y por el ligamento pisiunciforme, hacia dentro (pared interna) por el pisiforme y hacia delante (techo) por un desdoblamiento palmar del ligamento anular anterior del carpo, una expansión del músculo flexor carpi ulnaris y el músculo palmaris brevis. Al salir de este conducto, es decir, a nivel del extremo inferior del pisiforme, y a veces, en el mismo conducto, el nervio se divide en sus dos ramos terminales: ramas superficial y profunda (2) .El canal de Guyon en la mano se divide en tres zonas:zona 1,que abarca desde la entrada al canal de Guyon hasta la bifurcación del nervio cubital en sus ramas superficial y profunda (salida del canal); zona 2, que sólo contiene la rama profunda o motora que rodea la apófisis unciforme del hueso ganchoso por su lado interno, tras haber dado la rama destinada al músculo abductor digiti minimi, y RESUMENLa compresión del nervio cubital en el canal de Guyon es mucho menos frecuente que la compresión del nervio mediano en el canal carpiano o del nervio cubital en el codo, ocupando el tercer lugar dentro de los sín-dromes canaliculares del miembro superior, pero no por ello es rara.A diferencia de estos síndromes, es raro que aparezca de forma idiopática, siendo más frecuente que aparezca de forma secundaria a causas locales, por lo que, a parte del EMG, es más frecuente la utilización de otras pruebas complementarias (RM, TAC, Doppler) para completar el diagnóstico. También puede aparecer como consecuencia de microtraumatismos profesionales, y, dentro de las formas traumáticas, es muy rara la lesión aislada de la rama motora debido a un traumatismo penetrante. Es fundamental conocer la anatomía de esta zona porque esto nos permitirá hacer un diagnóstico clínico relativamente fácil y precisar el lugar de la compresión, porque anatómicamente este canal se divide en tres zonas, pero además porque es preciso conocer las relaciones anatómicas de este espacio para evitar complicaciones o lesiones iatrogénicas del nervio cubital tras la cirugía del canal carpiano, que se pueden producir a través de la zona central de su pared interna que sólo está ocupada por tejido adiposo, pues el canal de Guyon no es un canal rígido sino un conducto osteofibroso, tal como lo describió Guyon en 1861. PALABRAS CLAVES IntroducciónLa compresión del nervio cubital en el canal de Guyon es mucho menos frecuente que la compresión del nervio mediano en el canal carpiano, pero no ...

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Peripheral Neuropathies of the Median, Radial, and Ulnar Nerves: MR Imaging Features

Cited by 279 publications

References 69 publications

Magnetic resonance imaging of the elbow

Magnetic resonance imaging of the elbow

Diffusion tensor imaging in carpal tunnel syndrome

Lesiones del nervio cubital en el canal de Guyon: a propósito de 6 casos

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