Ultrasound of Small Nerves

Abstract

Nerve ultrasound has become an integral part of the diagnostic workup of peripheral neuropathies. Especially in the examination of small nerves, ultrasound provides superior image quality by using high frequency transducers. For a selection of small nerves, this article summarizes the local anatomy and common pathologies and offers simple instructions for determining their location with ultrasound including some cases with pathologies. This selection of nerves comprises the great auricular nerve, the supraclavicular nerves, the suprascapular nerve, the medial antebrachial cutaneous nerve, the lateral antebrachial cutaneous nerve, the palmar cutaneous branch of the median nerve, the long thoracic nerve, the intercostobrachial nerve, the posterior cutaneous nerve, the infrapatellar branch of the saphenous nerve, the medial calcaneal nerve, and the deep peroneal nerve at the ankle. Following our recommendations, these nerves can be swiftly located and tracked along their course to the site of the pathology.

Ultrasound-guided medical procedures: a growing field with new opportunities

“…Mit dem technologischen Fortschritt wurde die Bildauflösung weiter erhöht, was die Ultraschall-Visualisierung von peripheren Nerven ermöglichte. Dies öffnete die Tür zur ultraschallgeführten Anästhesie von Nervenplexus und einzelnen Nerven [21,22]. In der Folge wurden sonografie-gestützte Interventionen und Biopsien an Nerven und neuralen Tumoren etabliert [23].…”

“…With technological advancements, image resolution was further improved, allowing for the ultrasonic visualization of peripheral nerves. This opened the door to ultrasound-guided anesthesia of the nerve plexus and single nerves [21,22]. Consequently, sonographically monitored therapeutic interventions and biopsies of nerves and neural tumors were established [23].…”

Visualization of sacral nerve roots and sacral plexus on gynecological transvaginal ultrasound: feasibility study

“…Ultrasonography has, meanwhile, become an excellent modality for the imaging of peripheral nerves with a superficial course 3,4 . However, the SP runs deep in the pelvis, on the anterior surface of the sacrum, inaccessible to a transabdominal anterior approach.…”

“…Neither in the routine nor the extended pelvic TVS examination is visualization of the sacral plexus (SP) included, as it has been assumed that these nerves cannot be visualized on ultrasound. Ultrasonography has, meanwhile, become an excellent modality for the imaging of peripheral nerves with a superficial course 3,4 . However, the SP runs deep in the pelvis, on the anterior surface of the sacrum, inaccessible to a transabdominal anterior approach.…”

‘Ultrasound Examination’ of the Musculoskeletal System: Bibliometric/Visualized Analyses on the Terminology (Change)

“…Many researchers have suggested ways to use the US probe to perform various steps of physical examination [ 4 , 8 , 9 , 10 ]. For instance, sono-palpation (or sono-Tinel in case of nerve imaging) is sometimes second to none for prompting the exact cause of a painful complaint while imaging/examining the patient [ 11 , 12 ]. Further, with the possibility of physician–patient interaction during the examination, ‘self-palpation’ might even be used [ 13 ].…”