Learning objectives
To demonstrate the use of ultrasound in radial nerve imaging
To review the sonographic appearance of radial nerve injury
Background
Radial nerve palsy has been described in association with fracture,
particularly at the humeral shaft,
and with penetrating injury such as stabbing or gunshot wounds.
The radial nerve may also be injured iatrogenically,
commonly in relation to fracture repair.
As the radial nerve can be nicely traced using ultrasound,
sonography is extremely useful for theassessment of radial nerve injury.
This review will discuss technique for imaging the radial nerve on sonography,
and will provide a case-based pictorial review of the sonographic appearance of radial nerve...
Imaging findings OR Procedure Details
ULTRASOUND IMAGING TECHNIQUE
For successful upper extremity peripheral nerve imaging,
high-resolution transducers are recommended.
At our institution,
12-18 MHz transducers are routinely employed.
NORMAL SONOGRAPHIC APPEARANCE OF THE RADIAL NERVE
The easiest way to identify the radial nerve is at the level of the distal humerus.
With the arm supinated,
the transducer is placed at the radial aspect of the distal upper arm,
just above the antecubital fossa (Figure 1).
The resultant image will be one of the brachioradialis at the level of the capitellum....
Conclusion
Sonography is useful in the imaging of radial nerve trauma,
with ability to detect injury related to fracture and surgical hardware.
References
US of the Peripheral Nerves of the Upper Extremity: A Landmark Approach.
Brown JM,
Yablon CM,
Morag Y,
Brandon CJ,
Jacobson JA.
Radiographics.
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Miller TT,
Reinus WR.
Nerve entrapment syndromes of the elbow,
forearm,
and wrist.
AJR Am J Roentgenol.
2010;195(3):585-94.
Beekman R,
Visser LH.
High-resolution sonography of the peripheral nervous system -- a review of the literature.
Eur J Neurol.
2004;11(5):305-14.
Ultrasound evaluation of focal neuropathies in athletes: a clinically-focused review.
Peck E,
Strakowski JA.
Br J Sports Med.
2015 Feb;49(3):166-75.
Management...