scholarly journals Reference values for the cross-sectional area of normal radial nerve at two levels using high-resolution ultrasonography

2021 ◽  
Vol 21 (85) ◽  
pp. e112-e126
Author(s):  
Kunwar Pal Singh ◽  
◽  
Achal Singh Goindi ◽  
Kamlesh Gupta
Keyword(s):  
High Resolution ◽  
Reference Values ◽  
Radial Nerve ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Level 1 ◽  
The Cross ◽  
High Resolution Ultrasonography ◽  
Level 2

Aim of the study: High-resolution ultrasound is less often used to evaluate the radial nerves. The radial nerve is often involved in entrapment syndromes. The aim of the study is to establish the reference values for the cross-sectional area of the normal radial nerve on high-resolution ultrasonography, and to identify relationships between the cross-sectional area and the subject’s age, gender, height, weight, body mass index, and hand dominance. Material and methods: The study was conducted on 200 subjects of both sexes, between 18 and 75 years of age, who did not have history of peripheral neuropathy or trauma to the upper limb. Highresolution real-time sonographic examination of the radial nerves was performed in both arms at two different levels. Level 1 was taken just proximal to the nerve bifurcation, and level 2 just after the nerve exits the spiral grove. Results: The mean cross-sectional area measured at level 2 (4.3 ± 0.4 mm2) was greater than that measured at level 1 (2.3 ± 0.3 mm2). No significant relationship was seen with age and hand dominance (p >0.05), but the cross-sectional area values at above mentioned levels were larger in males than in females (p <0.05). In addition, the cross-sectional areas of the radial nerves showed a positive correlation with height, weight, and body mass index (p <0.05). Conclusion: The established ultrasonographic reference values along with basic clinical data will aid in the diagnosis, response to treatment, and prognostic evaluation of peripheral neuropathies.

scholarly journals Reference values for the cross-sectional area of the normal sciatic nerve using high-resolution ultrasonography

2021 ◽  
Vol 21 (85) ◽  
pp. e95-e104
Author(s):  
Kunwar Pal Singh ◽  
◽  
Prabhjot Singh ◽  
Kamlesh Gupta
Keyword(s):  
High Resolution ◽  
Sciatic Nerve ◽  
Reference Values ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean ◽  
Sciatic Nerves ◽  
The Cross ◽  
High Resolution Ultrasonography

Aim: High-resolution ultrasonography is a new and promising technique to evaluate peripheral and spinal nerves. Its validity as a diagnostic tool in neurological diseases has been demonstrated in adults. The aims of study were to establish the reference values for the cross-sectional area of the normal sciatic nerve on high-resolution ultrasonography, and to determine the relationship between the cross-sectional area of the normal sciatic nerve and the subjects’ age, gender, height (in cm), weight (in kg), and body mass index. Material and methods: Two hundred subjects of both genders and above 18 years of age were studied with high-resolution ultrasonography. The subjects had no history of peripheral neuropathy or trauma to the lower limb. The cross-sectional areas of the normal sciatic nerves were obtained at two different levels in both lower limbs. The mean cross-sectional areas of the sciatic nerves were measured at two different levels, one located at 1 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves, and the other 4 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves. Results: A positive correlation of the mean cross-sectional area was established with height, weight, and body mass index. Women had smaller cross-sectional areas of the normal sciatic nerves than men at both measuring sites. No significant relationship was established with the age of the subjects. Conclusions: The established reference values of the cross-sectional area of the sciatic nerve can facilitate the analysis of pathological nerve conditions.

scholarly journals A T-capsulotomy provides increased hip joint visualization compared with an extended interportal capsulotomy

2019 ◽  
Vol 6 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Gregory L Cvetanovich ◽  
David M Levy ◽  
Edward C Beck ◽  
Alexander E Weber ◽  
Benjamin D Kuhns ◽  
...  
Keyword(s):  
High Resolution ◽  
Hip Joint ◽  
Cross Sectional Area ◽  
T Test ◽  
Sectional Area ◽  
Cross Sectional ◽  
Digital Photograph ◽  
Fresh Frozen ◽  
The Cross ◽  
Cadaveric Model

Abstract The purpose of this study was to compare the cross-sectional area (CSA) of joint visualization between extended interportal and T-capsulotomies. Twenty fresh-frozen cadaveric hips were dissected to their capsuloligamentous complexes and fixed in a custom apparatus in neutral hip position. Ten hips underwent sequential interportal capsulotomies at lengths of 2, 4, 6, and 8 cm. Ten hips underwent sequential T-capsulotomies starting from a 4 cm interportal capsulotomy, creating a 2 cm T-capsulotomy (Half-T), and finally a 4 cm T-capsulotomy (Full-T). Following each sequential capsule change in both groups, a high-resolution digital photograph was taken to measure the visualized intra-articular cross-sectional area (CSA). Independent t-test was used to compare CSA interportal and T-capsulotomy groups. Analysis demonstrated a statistically significant increase in CSA visualization with each sequential increase in interportal capsulotomy length up to 6 cm (2cm: 0.6 ± 0.2 cm2; 4cm: 2.1 ± 0.5 cm2 (p<0.001); 6cm: 3.6 ± 1.0 cm2 (p=0.001)), and no difference at 8cm (4.2 ± 1.2 cm2 (p=0.20)). For the T-capsulotomy group the average CSA visualization significantly increased from 3.2 ± 0.9 cm2 for the Half-T to 7.1 ± 1.0 cm2 for the Full-T (p<0.001). The Half-T CSA visualization was not statistically different from the 6 cm capsulotomy (p=0.4) and the 8cm capsulotomy (p=0.05). The Full-T had significantly superior CSA visualization area as compared to the 6 cm and 8 cm interportal capsulotomies (p<0.001 for both). In conclusion, T-capsulotomy resulted in improved cross-sectional area of joint visualization compared to an extended (8cm) interportal capsulotomy in a cadaveric model. Surgeons must weigh the benefits of greater visualization from T-capsulotomy that may help to avoid residual FAI while ensuring to completely repair the capsulotomy to avoid iatrogenic instability.

scholarly journals High-resolution ultrasound in the assessment of peripheral nerves in leprosy: A comparative cross-sectional study

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Kalathummarath Sreejith ◽  
Sarita Sasidharanpillai ◽  
Kidangazhiathmana Ajithkumar ◽  
Reeba Mary Mani ◽  
Anuradha Thalian Chathoth ◽  
...  
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Clinical Examination ◽  
Peripheral Nerves ◽  
Cross Sectional Area ◽  
Nerve Function ◽  
Sectional Area ◽  
Cross Sectional ◽  
Function Impairment ◽  
The Cross

Background: Detection of peripheral nerve thickening and nerve function impairment is crucial in the diagnosis and the management of leprosy. Aims and objectives: (1) To document the cross-sectional area, echotexture and blood flow of peripheral nerves in healthy controls and leprosy cases using high-resolution ultrasound, (2) to compare the sensitivities of clinical examination and high-resolution ultrasound in detecting peripheral nerve thickening in leprosy. Methods: Peripheral nerves of 30 leprosy patients and 30 age- and sex-matched controls were evaluated clinically and by high-resolution ultrasound. When the cross-sectional area of a peripheral nerve on high-resolution ultrasound in a leprosy patient was more than the calculated upper bound of the 95% confidence interval for mean for that specific nerve in controls, that particular peripheral nerve was considered to be enlarged. Results: Cross-sectional areas more than 7.1 mm2 for the radial nerve, 8.17 mm2 for ulnar, 10.17 mm2 for median, 9.50 mm2 for lateral popliteal and 11.21mm2 for the posterior tibial nerve were considered as nerve thickening on high-resolution ultrasound. High-resolution ultrasound detected 141/300 (47%) nerves enlarged in contrast to the 60 (20%) diagnosed clinically by palpation (P < 0.001). Clinical examination identified thickening in 31/70 (44.3%) nerves in cases with impairment of nerve function and 29/230 (12.6%) in the absence of nerve function impairment. High-resolution ultrasound detected thickening in 50/70 (71.4%) nerves with impairment of function and in 91/230 (39.6%) nerves without any impairment of function. Limitation: A single-centre study design was the major study limitation. Conclusion: High-resolution ultrasound showed greater sensitivity than clinical examination in detecting peripheral nerve thickening in leprosy cases. High-resolution ultrasound, may therefore improve the sensitivity of the diagnostic criterion of peripheral nerve enlargement in the diagnosis and classification of leprosy.

scholarly journals Role of High-Resolution Ultrasonography in Evaluation of Median Nerve and Thickness of Flexor Retinaculum in Patients with Hypothyroidism

2020 ◽  
Vol 2 ◽  
pp. 36-43
Author(s):  
Kunwar Pal Singh ◽  
Kamlesh Gupta ◽  
Iqbaljit Kaur ◽  
Vijinder Arora
Keyword(s):  
High Resolution ◽  
Healthy Volunteers ◽  
Median Nerve ◽  
Cross Sectional Area ◽  
Width Ratio ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flexor Retinaculum ◽  
Nerve Fascicle ◽  
High Resolution Ultrasonography

Objectives: To determine the role of high resolution ultrasonography in evaluation of cross sectional area, maximum nerve fascicle thickness and thickness/width ratio of the median nerve and flexor retinaculum thickness in patients with hypothyroidism and to correlate it with the healthy volunteers. Material and Methods: A prospective study was conducted from February 2018 to October 2019 on 62 patients which included 32 clinically proven cases of hypothyroidism and 30 healthy volunteers. High resolution ultrasonography was performed using high frequency linear probes. Results: The most affected parameter was cross sectional area of median nerve at three levels, inlet/outlet ratio of CSA of the median nerve and thickness of flexor retinaculum in hypothyroidism patients in correlation with healthy volunteers. These parameters showed statistically significant p values. Maximum nerve fascicle thickness and thickness/width ratio of the median nerve showed no statistical significance in hypothyroid patients in correlation with healthy volunteers. Conclusion: High-resolution ultrasonography plays an important role in evaluating the changes occuring in cross sectional area of the median nerve, its inlet/outlet CSA ratio and flexor retinaculum thickness in hypothyroidism patients as correlated with the healthy volunteers.

The thickness of the A2 pulley and the flexor tendon are related to the severity of trigger finger: results of a prospective study using high-resolution ultrasonography

2015 ◽  
Vol 41 (2) ◽  
pp. 204-211 ◽  
Author(s):  
S.-J. Kim ◽  
C.-H. Lee ◽  
W.-S. Choi ◽  
B.-G. Lee ◽  
J.-H. Kim ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Proximal Part ◽  
Cross Sectional Area ◽  
Trigger Finger ◽  
Sectional Area ◽  
Cross Sectional ◽  
A2 Pulley ◽  
The Cross ◽  
High Resolution Ultrasonography ◽  
A1 Pulley

We aimed to investigate the relationship between the pulley-tendon complexes and the severity of trigger finger. The thickness of the A1 and A2 pulleys, and the cross-sectional area of the flexor tendon under the pulleys, were prospectively assessed using 17 MHz high-resolution ultrasonography, in 20 patients with trigger finger (31 fingers). A control group comprised 15 asymptomatic fingers. The thickness of the A1 pulley and the proximal part of the A2 pulley, and the cross-sectional area of the flexor tendon under the A2 pulley, were significantly increased in the patient group. Clinical grade was significantly correlated with the thickness of the A1 pulley, the thickness of the proximal part of the A2 pulley, and the cross-sectional area of the flexor tendon under the proximal part of the A2 pulley. This study confirmed that the thickness of the A2 pulley and flexor tendon under the A2 pulley seems to be related to the severity of trigger finger. Level of evidences: Level III

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