Peripheral Nerve Ultrasound: from Clinic to Operating Room

Abstract

Nerve ultrasound is a simple, low-cost modality that provides dynamic and functional, real-time images of the peripheral nerves which can provide vital information in the diagnosis of peripheral nerve pathology. This article describes the merit of nerve ultrasound in two challenging cases of radial nerve injuries treated in a tertiary hospital. Preoperative nerve ultrasound suggested the site and extent of the injured nerve by precise segmental difference in the nerve thickness which correlated intraoperatively to the edematous neural tissue and surrounding scar adherent to the nerve. Post-operative serial ultrasound imaging indicated decrease in the thickness of the effected nerve indicating recovery. Nerve ultrasound is a useful modality in peripheral nerve injury for precise preoperative planning, for precise surgical incision, area with extent of exploration, and length of nerve graft to be taken for repair. When post-operatively done serially, it is also beneficial in prognosticating surgical outcome. Peripheral nerve ultrasound will be a useful tool to be done in the routine evaluation of peripheral nerve injuries following clinical examination and electrophysiological tests. MRI is to be considered as an additional investigation if nerve ultrasound study is non-contributory.