Ultrasound of the Brachial Plexus

2018 ◽  
Vol 22 (03) ◽  
pp. 323-333 ◽  
Author(s):  
James Griffith
Keyword(s):  
Brachial Plexus ◽  
Soft Tissues ◽  
High Spatial Resolution ◽  
Nerve Sheath Tumor ◽  
Common Variants ◽  
Ultrasound Technique ◽  
Neuralgic Amyotrophy ◽  
Inflammatory Neuropathies ◽  
The Common ◽  
Perineural Fibrosis

AbstractExamination of the brachial plexus with ultrasound is efficient because it allows many parts of the brachial plexus as well as the surrounding soft tissues to be assessed with high spatial resolution. The key to performing good ultrasound of the brachial plexus is being familiar with the anatomy and the common variants. That makes it possible to concentrate solely on the ultrasound appearances free of simultaneously wondering about the anatomy. Ultrasound of the brachial plexus is particularly good for assessing nerve sheath tumor, perineural fibrosis, metastases, some inflammatory neuropathies, neuralgic amyotrophy, and posttraumatic sequalae. It is limited in the assessment of thoracic outlet syndrome and in the acute/subacute trauma setting. This review addresses the anatomy, ultrasound technique, as well as pathology of the brachial plexus from the cervical foramina to the axilla.

scholarly journals Anatomical Study of the Brachial Plexus in the Common Marmoset (Callithrix Jacchus )

2017 ◽  
Vol 300 (7) ◽  
pp. 1299-1306 ◽  
Author(s):  
Kenji Emura ◽  
Takamitsu Arakawa ◽  
Toshio Terashima
Keyword(s):  
Brachial Plexus ◽  
Anatomical Study ◽  
Common Marmoset ◽  
Callithrix Jacchus ◽  
The Common

scholarly journals Nodes, paranodes and neuropathies

2017 ◽  
Vol 89 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Janev Fehmi ◽  
Steven S Scherer ◽  
Hugh J Willison ◽  
Simon Rinaldi
Keyword(s):  
Peripheral Nerves ◽  
Clinical Importance ◽  
Specific Cell ◽  
Peripheral Neuropathies ◽  
Autoimmune Neuropathy ◽  
Basic Understanding ◽  
Clinical Variants ◽  
Inflammatory Neuropathies ◽  
The Common ◽  
Treatment Responsiveness

This review summarises recent evidence supporting the involvement of the specialised nodal and perinodal domains (the paranode and juxtaparanode) of myelinated axons in the pathology of acquired, inflammatory, peripheral neuropathies.The identification of new target antigens in the inflammatory neuropathies heralds a revolution in diagnosis, and has already begun to inform increasingly targeted and individualised therapies. Rapid progress in our basic understanding of the highly specialised nodal regions of peripheral nerves serves to strengthen the links between their unique microstructural identities, functions and pathologies. In this context, the detection of autoantibodies directed against nodal and perinodal targets is likely to be of increasing clinical importance. Antiganglioside antibodies have long been used in clinical practice as diagnostic serum biomarkers, and associate with specific clinical variants but not to the common forms of either acute or chronic demyelinating autoimmune neuropathy. It is now apparent that antibodies directed against several region-specific cell adhesion molecules, including neurofascin, contactin and contactin-associated protein, can be linked to phenotypically distinct peripheral neuropathies. Importantly, the immunological characteristics of these antibodies facilitate the prediction of treatment responsiveness.

scholarly journals Groin Flap for Salvage of Upper Extremity Following Necrotizing Fasciitis: A Case Report

2005 ◽  
Vol 13 (3) ◽  
pp. 153-155
Author(s):  
Chenicheri Balakrishnan ◽  
Venkata S Erella ◽  
Shawn Vandemark ◽  
Jason Mussman
Keyword(s):  
Upper Extremity ◽  
Soft Tissues ◽  
Skin Grafting ◽  
Surgical Excision ◽  
Soft Tissue Infections ◽  
Significant Morbidity ◽  
Groin Flap ◽  
Necrotizing Soft Tissue Infections ◽  
Extensive Debridement ◽  
The Common

Necrotizing soft tissue infections are often associated with significant morbidity and mortality Early surgical excision along with antibiotic therapy is the cornerstone of management. Salvage of these extremities is often difficult due to loss of soft tissues, tendons, nerves and blood vessels. Skin grafting of the granulating wound is the common method of closure in these patients. Use of various flaps has improved reconstructive options in these extremities. A case of salvage of upper extremity using a groin flap following extensive debridement is reported.

Orthopaedic surgery

2014 ◽  
Author(s):  
Sebastian Dawson-Bowling
Keyword(s):  
Fracture Healing ◽  
Orthopaedic Surgery ◽  
Soft Tissues ◽  
Orthopaedic Practice ◽  
Non Union ◽  
Valuable Adjunct ◽  
The Common ◽  
Musculoskeletal Function ◽  
Comprehensive History ◽  
Primary Modality

Sound knowledge of anatomy and understanding of musculoskeletal function underpins good orthopaedic practice. Bones and joints may be affected by genetic and degenerative conditions, by infection, primary and secondary neoplasia, by endocrine and metabolic anomalies, and by trauma. As in other areas of surgery, a comprehensive history and thorough examination are essential in leading the clinician to a correct diagno­sis. Appropriate imaging complements clinical acuity. The plain X-ray remains the primary modality of investigation for visualizing bony injuries and pathology, but MRI is a valuable adjunct for investigating soft tissues and joints. Principles of fracture healing, reduction and fixation, and knowledge of consequences of complications which delay healing, or cause non-union, are integral to the practice of orthopaedic surgery. This chapter will help you to revise basic tenets of orthopaedic prac­tice and the common injuries and conditions encountered by the ortho­paedic surgeon.

scholarly journals Rhabdomyosarcoma of the Oral Cavity: A Case Report

2011 ◽  
Vol 05 (03) ◽  
pp. 340-343 ◽  
Author(s):  
Ozkan Miloglu ◽  
Sare Sipal Altas ◽  
Mustafa Cemil Buyukkurt ◽  
Burak Erdemci ◽  
Oguzhan Altun
Keyword(s):  
Skeletal Muscle ◽  
Case Report ◽  
Soft Tissue ◽  
Oral Cavity ◽  
Head And Neck ◽  
Soft Tissues ◽  
Neck Region ◽  
Childhood And Adolescence ◽  
Head And Neck Region ◽  
The Common

ABSTRACTRhabdomyosarcoma (RMS), a tumor of skeletal muscle origin, is the most common soft tissue sarcoma encountered in childhood and adolescence. The common sites of occurrence are the head and neck region, genitourinary tract, retroperitonium, and, to a lesser extent, the extremities. In the head and neck region, the most commonly affected sites are the orbit, paranasal sinuses, soft tissues of the cheek, and the neck. RMS is relatively uncommon in the oral cavity, and the involvement of the jaws is extremely rare. Here, we report a case of oral RMS in a 13-year-old child and describe the clinical, radiological, histopathological, and immunohistochemical findings. (Eur J Dent 2011;5:340-343)

scholarly journals Clinical phenotype and outcome of hepatitis E virus–associated neuralgic amyotrophy

Neurology ◽  
2017 ◽  
Vol 89 (9) ◽  
pp. 909-917 ◽  
Author(s):  
Jeroen J.J. van Eijk ◽  
Harry R. Dalton ◽  
Paolo Ripellino ◽  
Richard G. Madden ◽  
Catherine Jones ◽  
...  
Keyword(s):  
Liver Function ◽  
Brachial Plexus ◽  
Hepatitis E Virus ◽  
Clinical Laboratory ◽  
Clinical Phenotype ◽  
Hepatitis E ◽  
Genotype 3 ◽  
Laboratory Findings ◽  
Neuralgic Amyotrophy ◽  
Extensive Damage

Objective:To determine the clinical phenotype and outcome in hepatitis E virus–associated neuralgic amyotrophy (HEV-NA).Methods:Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection.Results:Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12–2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, p < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, p < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, p = 0.01, and 26.4% vs 7.0%, p = 0.001), reduced reflexes (p = 0.03), sensory symptoms (p = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months.Conclusions:Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted.

scholarly journals Research on calcifications in the cervical region using panoramic and teleradiographic techniques

2016 ◽  
Vol 64 (3) ◽  
pp. 280-286
Author(s):  
Rosangela Sayuri Saga KAMIKAWA ◽  
Ricardo RAITZ ◽  
Marlene Fenyo PEREIRA
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Soft Tissues ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cervical Region ◽  
Panoramic Radiographs ◽  
Intraclass Correlation Coefficients ◽  
Gutta Percha ◽  
The Common

ABSTRACT Objective: The aim of the study was to evaluate the contribution of lateral and frontal teleradiographs to the identification and location of calcifications in soft tissues, when compared with those observed in panoramic radiographs. Methods: Radiopaque references in gutta-percha were placed unilaterally on the heads of three cadavers, endeavoring at all times to keep to the same level as the bifurcation of the common carotid artery in different structures, sites of possible calcifications, and three radiographic incidences were obtained for each anatomic part. Thus, the sample of this study was composed of 27 panoramic radiographs, 27 lateral teleradiographs and 27 frontal teleradiographs, totaling 81 radiographs. Results: According to the criteria of Cicchetti and Sparrow, the intraclass correlation coefficients (ICCs) obtained were below 0.40. Conclusion: It can be concluded that the lateral and frontal teleradiographs did not contribute efficiently to the identification and location of radiopacities in the cervical region, and that the anatomic conformation interferes in the observation of the presence of radiopacity in the cervical region.

Cervical radiculopathy, entrapment neuropathy, and thoracic outlet syndrome: how to differentiate?

2004 ◽  
Vol 1 (2) ◽  
pp. 179-187 ◽  
Author(s):  
John E. McGillicuddy
Keyword(s):  
Older Patients ◽  
Thoracic Outlet Syndrome ◽  
Cervical Radiculopathy ◽  
Sensory Loss ◽  
Neuralgic Amyotrophy ◽  
Content Type ◽  
Arm Pain ◽  
Entrapment Neuropathies ◽  
The Common ◽  
Fine Print

✓ The common diagnoses of cervical radiculopathy and upper-extremity entrapment neuropathies can at times be difficult to differentiate. Additionally, thoracic outlet syndrome is often diagnosed when, in fact, the problem is radiculopathy or neuropathy. Another source of confusion, especially in older patients, is neuralgic amyotrophy, brachial plexitis, or the Parsonage—Turner syndrome. The differential diagnosis of unilateral arm pain, weakness, and/or sensory loss includes all of these problems. The clinical and electrodiagnostic features of each are discussed as an aid to distinguishing between these common and similar entities.

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