Reliability and Size of the Measurement Error when Determining the Cross-Sectional Area of the Tibial Nerve at the Tarsal Tunnel with Ultrasonography

Alshami, Ali; Cairns, Craig W.; Wylie, Bridie; Souvlis, Tina; Coppieters, Michel W.

doi:10.1016/j.ultrasmedbio.2009.01.011

Cited by 53 publications

(36 citation statements)

References 17 publications

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“…Variations in methods in the current literature give a variation in results and make the studies difficult to compare (11,12,(16)(17)(18)(19)(20)(21). For example, Lee and Dauphinée (11) found an increased CSA using ultrasound in patients with DPN (24 mm 2 ) compared with healthy control subjects (12 mm 2 ).…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound Findings After Surgical Decompression of the Tarsal Tunnel in Patients With Painful Diabetic Polyneuropathy: A Prospective Randomized Study

et al. 2014

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OBJECTIVEIt has been hypothesized that the development of diabetic polyneuropathy (DPN) is due to swelling of the nerve, as well as thickening and stiffening of the surrounding ligaments, causing chronic compression of nerves. We aimed to examine the effect of surgical decompression of the tibial nerve on the mean cross-sectional area (CSA). RESEARCH DESIGN AND METHODSWe performed a randomized controlled trial of 42 subjects with painful DPN diagnosed using the Diabetic Neuropathy Score. A computer randomized for the surgery arm of the study. A control group consisting of 38 healthy subjects was included. An experienced sonographer measured the CSA and thickness-to-width (T/W) ratio of the tibial nerve, as well as the thickness of the flexor retinaculum. RESULTSCSA is significantly larger in patients with painful DPN (8.4 6 3.9 mm 2 ) than in control subjects (6.4 6 1.3 mm 2 ), P = 0.007. The T/W ratio in patients with painful DPN is 0.64 and in control subjects 0.59, P = 0.03. Patients with DPN have a significantly thicker retinaculum (1.07 mm) than control subjects (0.84 mm), P < 0.001. Mean follow-up was 28.2 weeks (range 23-45). Difference between baseline and follow-up in the operated leg was 1.49 mm 2 and in the control leg 1.81 mm 2 , P = 0.674. CONCLUSIONSDecompression of the tibial nerve does not result in a significant difference between baseline and follow-up in CSA using ultrasound between the operated and control leg. Ultrasound measurements show a significantly increased CSA, a significantly thicker retinaculum, and a significantly increased T/W ratio in patients with painful DPN compared with healthy control subjects.

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Section: Discussionmentioning

confidence: 99%

“…Four studies evaluated healthy individuals and describe CSAs between 7.9 and 13.7 mm 2 . All the CSAs were measured at different locations in the ankle (16)(17)(18)20 (12,21).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Findings After Surgical Decompression of the Tarsal Tunnel in Patients With Painful Diabetic Polyneuropathy: A Prospective Randomized Study

et al. 2014

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“…Several reports have been published on reference values for the cross-sectional areas of the median and ulnar nerves [10][11][12][13][14][15][16][17], with a good agreement among the measurements. On the other hand, data are less abundant concerning normal values for cervical roots, radial nerve, lower limb nerves and pure sensory nerves [15][16][17][18][19][20][21][22][23][24][25], and they show more variation among studies. Some studies have reported values for intra-and inter-rater reliability [24][25][26][27], but inter-equipment reliability has not been hitherto addressed.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, data are less abundant concerning normal values for cervical roots, radial nerve, lower limb nerves and pure sensory nerves [15][16][17][18][19][20][21][22][23][24][25], and they show more variation among studies. Some studies have reported values for intra-and inter-rater reliability [24][25][26][27], but inter-equipment reliability has not been hitherto addressed.…”

Section: Introductionmentioning

confidence: 99%

High-Resolution Ultrasonography of Peripheral Nerves: Measurements on 14 Nerve Segments in 56 Healthy Subjects and Reliability Assessments

Boehm¹,

Scheidl

Bereczki

et al. 2014

Ultraschall in Med

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Purpose: The aim of this study was to assess different aspects of reliability in high resolution ultrasonography (HRUS) of the peripheral nerves and to establish reference values for the most frequently examined nerve segments. Materials and Methods:A nerve size parameter, the cross-sectional area (CSA) of the C5, C6 and C7 cervical roots, the median, ulnar, radial, superficial radial, peroneal, tibial, and the sural nerves was measured using HRUS at altogether 14 predefined anatomical sites in two different cohorts of healthy subjects (n=56), and the inter-rater, intra-rater and interequipment reliability of measurements was assessed.Results: Mean CSA of the 14 nerve segments ranged from 2 to 10 mm 2 . Intra-rater, inter-rater and inter-equipment reliability was high with intraclass correlation coefficients of 0.93, 0.98, and 0.86, respectively. CSA values showed no consistent correlation with age, height, and body weight, but males had significantly larger values than females for nerve segments on the arm after correcting for age, weight and height in multivariate analysis. CSA values did not differ when two independent cohorts were compared. Conclusion:Peripheral nerve ultrasonography is a reliable and reproducible diagnostic method in the hands of experienced examiners. Normal values for several upper and lower extremity nerves are provided by our study.

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“…Alshami et al [1] states that high-resolution US is reliable to measure the crosssectional area of a peripheral nerve.…”

Section: Imaging Methodologiesmentioning

confidence: 99%

The tarsal tunnel syndrome

Prado¹,

Cuervas-Mons

Golanó

et al. 2015

Fuß & Sprunggelenk

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Reliability and Size of the Measurement Error when Determining the Cross-Sectional Area of the Tibial Nerve at the Tarsal Tunnel with Ultrasonography

Cited by 53 publications

References 17 publications

Ultrasound Findings After Surgical Decompression of the Tarsal Tunnel in Patients With Painful Diabetic Polyneuropathy: A Prospective Randomized Study

Ultrasound Findings After Surgical Decompression of the Tarsal Tunnel in Patients With Painful Diabetic Polyneuropathy: A Prospective Randomized Study

High-Resolution Ultrasonography of Peripheral Nerves: Measurements on 14 Nerve Segments in 56 Healthy Subjects and Reliability Assessments

The tarsal tunnel syndrome

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