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High-resolution 3-T MR neurography of peroneal neuropathy

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Abstract

The common peroneal nerve (CPN), a major terminal branch of the sciatic nerve, can be subject to a variety of pathologies, which may affect the nerve at any level from the lumbar plexus to its distal branches. Although the diagnosis of peripheral neuropathy is traditionally based on a patient’s clinical findings and electrodiagnostic tests, magnetic resonance neurography (MRN) is gaining an increasing role in the definition of the type, site, and extent of peripheral nerve disorders. Current high-field MR scanners enable high-resolution and excellent soft-tissue contrast imaging of peripheral nerves. In the lower extremities, MR neurography has been employed in the demonstration of the anatomy and pathology of the CPN, as well as in the detection of associated secondary muscle denervation changes. This article reviews the normal appearance of the CPN as well as typical pathologies and abnormal findings at 3.0-T MR neurography of the lower extremity.

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References

  1. Chhabra A, Williams EH, Wang KC, Dellon AL, Carrino JA. MR Neurography of neuromas related to nerve injury and entrapment with surgical correlation. AJNR Am J Neuroradiol. 2010;31:1363–8.

    Article  PubMed  CAS  Google Scholar 

  2. Thawait SK, Chaudhry V, Thawait GK, et al. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol. 2010 (EPUB).

  3. Filler AG, Haynes J, Jordan SE, et al. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine. 2005;2:99–115.

    Article  PubMed  Google Scholar 

  4. Filler A. Magnetic resonance neurography and diffusion tensor imaging: origins, history, and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5,000-patient study group. Neurosurgery. 2009;65(4 Suppl):29–43.

    Article  Google Scholar 

  5. Kim JY, Ihn YK, Kim JS, Chun KA, Sung MS, Cho KH. Non-traumatic peroneal nerve palsy: MRI findings. Clin Radiol. 2007;62(1):58–64.

    Article  PubMed  CAS  Google Scholar 

  6. Heilbrun ME, Tsuruda JS, Townsend JJ, Heilbrun MP. Intraneural perineurioma of the common peroneal nerve. Case report and review of the literature. J Neurosurg. 2001;94(5):811–5.

    Article  PubMed  CAS  Google Scholar 

  7. Hof JJ, Kliot M, Slimp J, Haynor DR. What’s new in MRI of peripheral nerve entrapment? Neurosurg Clin N Am. 2008;19(4):583–95.

    Article  PubMed  Google Scholar 

  8. Loredo R, Hodler J, Pedowitz R, Yeh LR, Trudell D, Resnick D. MRI of the common peroneal nerve: normal anatomy and evaluation of masses associated with nerve entrapment. J Comput Assist Tomogr. 1998;22(6):925–31.

    Article  PubMed  CAS  Google Scholar 

  9. Martinoli C, Bianchi S, Gandolfo N, Valle M, Simonetti S, Derchi LE. US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. Radiographics. 2000 Oct;20 Spec No:S199-213; discussion S213-7. Radiographics. 2000;20(6):1818.

    Google Scholar 

  10. Visser LH. High-resolution sonography of the common peroneal nerve: detection of intraneural ganglia. Neurology. 2006;67(8):1473–5.

    Article  PubMed  Google Scholar 

  11. Gruber H, Peer S, Meirer R, Bodner G. Peroneal nerve palsy associated with knee luxation: evaluation by sonography–initial experiences. AJR Am J Roentgenol. 2005;185(5):1119–25.

    Article  PubMed  Google Scholar 

  12. Hahn AF, Mauermann ML, Dyck PJ, Keegan BM. A 16-year-old girl with progressive weakness of the left leg. Neurology. 2007;69(1):84–90.

    Article  PubMed  Google Scholar 

  13. McCrory P, Bell S, Bradshaw C. Nerve entrapments of the lower leg, ankle and foot in sport. Sports Med. 2002;32(6):371–91.

    Article  PubMed  Google Scholar 

  14. El Gharbawy RM, Skandalakis LJ, Skandalakis JE. Protective mechanisms of the common fibular nerve in and around the fibular tunnel: a new concept. Clin Anat. 2009;22(6):738–46.

    Article  PubMed  Google Scholar 

  15. Vieira RL, Rosenberg ZS, Kiprovski K. MRI of the distal biceps femoris muscle: normal anatomy, variants, and association with common peroneal entrapment neuropathy. AJR Am J Roentgenol. 2007;189(3):549–55.

    Article  PubMed  Google Scholar 

  16. Fabre T, Piton C, Andre D, Lasseur E, Durandeau A. Peroneal nerve entrapment. J Bone Joint Surg Am. 1998;80(1):47–53.

    PubMed  CAS  Google Scholar 

  17. Sunderland S, Bradley KC. The cross-sectional area of peripheral nerve trunks devoted to nerve fibers. Brain. 1949;72(3):428–49.

    Article  PubMed  CAS  Google Scholar 

  18. Aprile I, Caliandro P, La Torre G, Tonali P, Foschini M, Mondelli M, et al. Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment. J Peripher Nerv Syst. 2005;10(3):259–68.

    Article  PubMed  Google Scholar 

  19. Planner AC, Donaghy M, Moore NR. Causes of lumbosacral plexopathy. Clin Radiol. 2006;61:987–95.

    Article  PubMed  CAS  Google Scholar 

  20. Edwards Jr PH, Wright ML, Hartman JF. A practical approach for the differential diagnosis of chronic leg pain in the athlete. Am J Sports Med. 2005;33(8):1241.

    Article  PubMed  Google Scholar 

  21. McCrory P, Bell S, Bradshaw C. Nerve entrapment of the lower leg, ankle and foot in sport. Sports Med. 2002;32:371–91.

    Article  PubMed  Google Scholar 

  22. Bendszus M, Wessig C, et al. MR imaging in the differential diagnosis of neurogenic foot drop. AJNR Am J Neuroradiol. 2003;24:1283–9.

    PubMed  Google Scholar 

  23. Masakado Y, Kawakami M, Suzuki K, Abe L, Ota T, Kimura A. Clinical neurophysiology in the diagnosis of peroneal nerve palsy. Keio J Med. 2008;57(2):84–9.

    Article  PubMed  Google Scholar 

  24. Kim S, Choi JY, Huh YM, et al. Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity. Eur Radiol. 2007;17:139–49.

    Article  PubMed  Google Scholar 

  25. Viallon M, Vargas MI, Jlassi H, Lovblad KO, Delavelle J. High-resolution and functional magnetic resonance imaging of the brachial plexus using an isotropic 3D T2 STIR (Short Term Inversion Recovery) SPACE sequence and diffusion tensor imaging. Eur Radiol. 2008;18:1018–23.

    Article  PubMed  CAS  Google Scholar 

  26. Zhang Z, Meng Q, Chen Y, et al. 3-T imaging of the cranial nerves using three-dimensional reversed FISP with diffusion-weighted MR sequence. J Magn Reson Imaging. 2008;27:454–8.

    Article  PubMed  Google Scholar 

  27. Stewart JD. Foot drop: where, why and what to do? Pract Neurol. 2008;8(3):158–69.

    Article  PubMed  Google Scholar 

  28. Erman T, Tuna M, Göçer AI, Idan F, Akgül E, Zorludemir S. Postoperative radicular neuroma. Case report. Neurosurg Focus. 2001 Nov 15;11(5).

  29. Giannoudis PV, Kontakis G, Christoforakis Z, Akula M, Tosounidis T, Koutras C. Management, complications and clinical results of femoral head fractures. Injury. 2009;40(12):1245–51.

    Article  PubMed  CAS  Google Scholar 

  30. Montgomery AS, Birch R, Malone A. Entrapment of a displaced common peroneal nerve following knee ligament reconstruction. J Bone Joint Surg Br. 2005 Jun;87(6):861–2. Erratum in: J Bone Joint Surg Br. 2005;87(8):1166.

    Google Scholar 

  31. Ottomley N, Williams A, Birch R, Noorani A, Lewis A, Lavelle J. Displacement of the common peroneal nerve in posterolateral corner injuries of the knee. J Bone Joint Surg Br. 2005;87(9):1225–6.

    Article  Google Scholar 

  32. Williams EH, Williams CG, Rosson GD, Dellon AL. Combined peroneal and proximal tibial nerve palsies. Microsurgery. 2009;29(4):259–64.

    Article  PubMed  Google Scholar 

  33. Canella C, Demondion X, Guillin R, Boutry N, Peltier J, Cotton A. Anatomic study of the superficial peroneal nerve using sonography. AJR AM J Roentgenol. 2009;193(1):174–9.

    Article  PubMed  Google Scholar 

  34. Garozzo D, Ferraresi S, Buffatti P. Surgical treatment of common peroneal nerve injuries: indications and results. A series of 62 cases. J Neurosurg Sci. 2004;48(3):105–1.

    PubMed  CAS  Google Scholar 

  35. Cardelia JM, Dormans JP, Drummond DS, Davidson RS, Duhaime C, Sutton L. Proximal fibular osteochondroma with associated peroneal nerve palsy: a review of six cases. J Pediatr Orthop. 1995;15(5):574–7.

    Article  PubMed  CAS  Google Scholar 

  36. Elias WJ, Pouratian N, Oskouian RJ, Schirmer B, Burns T. Peroneal neuropathy following successful bariatric surgery. Case report and review of the literature. J Neurosurg. 2006;105(4):631–5.

    Article  PubMed  Google Scholar 

  37. Spinner RJ, Amrami KK, Wolanskyj AP, Desy NM, Wang H, Benarroch EE, et al. Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory. J Neurosurg. 2007;107:296–307.

    Article  PubMed  Google Scholar 

  38. Peeters EY, Neiboer KH, Osteaux MM. Sonography of the normal ulnar nerve at Guyon’s canal and of the common peroneal nerve dorsal to the fibular head. J Clin Ultrasound. 2004;32(8):375–80.

    Article  PubMed  Google Scholar 

  39. Spinner RJ, Desy NM, Amrami KK. Sequential tibial and peroneal intraneural ganglia arising from the superior tibiofibular joint. Skeletal Radiol. 2008;37(1):79–84.

    Article  PubMed  Google Scholar 

  40. Descamps MJ, Barrett L, Groves M, Yung L, Birch R, Murray NM, et al. Primary sciatic nerve lymphoma: a case report and review of the literature. J Neurol Neurosurg Psychiatry. 2006;77(9):1087–9.

    Article  PubMed  CAS  Google Scholar 

  41. Mahitchi E, Van Linthoudt D. Schwannoma of the deep peroneal nerve. An unusual presentation in rheumatology. Praxis (Bern 1994). 2007;96(3):69–72.

    Article  CAS  Google Scholar 

  42. Ladha SS, Dyck PJ, Spinner RJ, Perez DG, Zeldenrust SR, Amrami KK, et al. Isolated amyloidosis presenting with lumbosacral radiculoplexopathy: description of two cases and pathogenic review. J Peripher Nerv Syst. 2006;11(4):346–52.

    Article  PubMed  Google Scholar 

  43. Linssen WH, Steller EP, Spliet WG, Davies GA. Peroneal nerve compression by fibrous histiocytoma. J Neurol. 2000;247(1):68–9.

    Article  PubMed  CAS  Google Scholar 

  44. Nagel A, Greenebaum E, Singson RD, Rosenwasser MP, McCann PD. Foot drop in a long-distance runner. An unusual presentation of neurofibromatosis. Orthop Rev. 1994;23(6):526–30.

    PubMed  CAS  Google Scholar 

  45. Trăistaru R, Enăchescu V, Manuc D, Gruia C, Ghiluşi M. Multiple right schwannoma. Rom J Morphol Embryol. 2008;49(2):235–9.

    PubMed  Google Scholar 

  46. Yamamoto T, Maruyama S, Mizuno K. Schwannomatosis of the sciatic nerve. Skeletal Radiol. 2001;30(2):109–13.

    Article  PubMed  CAS  Google Scholar 

  47. Hruban RH, Shiu MH, Senie RT, Woodruff JM. Malignant peripheral nerve sheath tumors of the buttock and lower extremity. A study of 43 cases. Cancer. 1990;66:1253–65.

    Article  PubMed  CAS  Google Scholar 

  48. Yamashita T, Kwee TC, Takahara T. Whole-body magnetic resonance neurography. N Engl J Med. 2009;361(5):538–9.

    Article  PubMed  CAS  Google Scholar 

  49. Jebraj I, Rao A, Shyamkumar NK, Vidyasagar. Imaging of tender neuropathy in leprosy. Indian J Lepr. 2005;77(1):51–4.

    Google Scholar 

  50. Hanyu N, Ikeda S, Nakadai A, Yanagisawa N, Powell HC. Peripheral nerve pathological findings in familial amyloid polyneuropathy: a correlative study of proximal sciatic nerve and sural nerve lesions. Ann Neurol. 1989;25(4):340–50.

    Article  PubMed  CAS  Google Scholar 

  51. Pradat PF, Bouche P, Delanian S. Sciatic nerve moneuropathy: an unusual late effect of radiotherapy. Muscle Nerve. 2009;40(5):872–4.

    Article  PubMed  Google Scholar 

  52. Paulino AC. Late effects of radiotherapy for pediatric extremity sarcomas. Int J Radiat Oncol Biol Phys. 2004;60(1):265–74.

    Article  PubMed  Google Scholar 

  53. Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109–22.

    PubMed  CAS  Google Scholar 

  54. Kumar RS, Gopinath M. A rare cause of foot drop after radiofrequency ablation for varicose veins: case report and review of the literature. Neurol India. 2010;58(2):303–5.

    Article  PubMed  Google Scholar 

  55. Andreisek G, Nanz D, Weishaupt D, Pfammatter T. MR imaging–guided percutaneous sclerotherapy of peripheral venous malformations with a clinical 1.5-T unit: a pilot study. J Vasc Interv Radiol. 2009;20(7):879–87.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge Tim Phelps, Associate Professor and Medical Illustrator in the Department of Art as Applied to Medicine, The Johns Hopkins University, Baltimore, MD, for his great contribution in the illustration of the peroneal nerve.

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Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 North Caroline Street, JHOC 3262, Baltimore, MD, 21287, USA

    Avneesh Chhabra, Neda Faridian-Aragh, Majid Chalian, Theodoros Soldatos & Shrey K. Thawait

  2. Department of Plastic Surgery, Johns Hopkins Hospital, Baltimore, MD, USA

    Eric H. Williams

  3. Dellon Institutes for Peripheral Nerve Surgery, Baltimore, MD, USA

    Eric H. Williams

  4. Institute for Diagnostic Radiology, Department of Medical Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Gustav Andreisek

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  1. Avneesh Chhabra
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  2. Neda Faridian-Aragh
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  3. Majid Chalian
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  4. Theodoros Soldatos
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  5. Shrey K. Thawait
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  6. Eric H. Williams
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  7. Gustav Andreisek
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Correspondence to Avneesh Chhabra.

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AC acknowledges the support from GERRAF (GE), Siemens Medical Solutions, Integra Life Sciences on prospective evaluation of MR neurography techniques.

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Chhabra, A., Faridian-Aragh, N., Chalian, M. et al. High-resolution 3-T MR neurography of peroneal neuropathy. Skeletal Radiol 41, 257–271 (2012). https://doi.org/10.1007/s00256-011-1146-y

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  • DOI: https://doi.org/10.1007/s00256-011-1146-y

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