Learning objectives
The purpose of our educational exhibit is to:
1.
illustrate the normal anatomy and normal US appearance of the sciatic nerve;
2.
describe a systematic technique for US evaluation of such structure;
3.
produce anatomical schemes with didactic purpose and show correlations with sonographic imaging.
Background
The Sciatic nerve is the longest and thickest peripheral nerve of the human body,
with a diameter of about 2 cm.
It supplies motor and sensory innervation to the posterior aspect of the thigh and of the whole lower leg,
except for the medial aspect of the leg,
which is supplied by the Saphenous nerve (the terminal branch of the femoral nerve).
It originates from the ventral rami of spinal nerves L4-L5,
S1-S3.
It leaves the lesser pelvis,
where it is anterior to the piriformis...
Imaging findings OR Procedure Details
Landmarks at the gluteal region:
the gluteus maximum
the ischial spine
pudendal vessels
Landmarks at the upper thigh:
greater trochanter of the femur
ischial tuberosity
common tendon of hamstring muscles
Landmarks at the popliteal fossa:
popliteal artery and vein
The patient is prone on the examination table.
Palpate the anatomical bony reference structures: the greater trochanter of the femur and the ischial tuberosity.
Then place the transducer in the transverse plane on the ischial tuberosity,
where the common tendon of Hamstring muscles can be seen....
Conclusion
US presents equal specificity and greater sensitivity than MR imaging in the evaluation of sciatic nerve,
but allows also a quick,
real-time and dynamic imaging and the possibility to compare the US findings against the contralateral side.
References
Berta Kowalska,
Iwona Sudoł-Szopińska,
(2012),Normal and sonographic anatomy of selected peripheralnerves.
Part III: Peripheral nerves of the lower limb,
Journal of Ultrasonography 2012; 12: 148–16
Martinoli C (2010),
Imaging of the peripheral nerves.
Semin Musculoskelet Radiol 2010; 14: 461–462.
Peng P,
Tumber P(2008),
Ultrasound-guided interventional procedures for patients with chronic pelvic pain – adescription of techniques and review of literature.
Pain Physician 2008; 11: 215–224.
Gray H: Anatomy Descriptive and Applied.
Longman’s,
Green and CO,
London1935.
Philip W.H.
Peng,
(2008) Ultrasound-Guided Interventional Procedures for Patients...
Personal Information
Silvia Perugin Bernardi,
Department of Radiology,
E.O.
Ospedali Galliera,
Mura delle Cappuccine 14,
16128 Genova
Elena Massone,Department of Radiology,
University of Genoa,
via L.B.
Alberti 4,
16100,
Genoa.
Davide Orlandi,
Department of Radiology,
Ospedale Evangelico Internazionale,Corso Solferino 2,
16100 Genova
Alessandro Muda,Department of Radiology,
IRCCS Ospedale Policlinico San Martino,
Largo R.
Benzi 10,
1613Genova.
Enzo Silvestri,
Department of Radiology,
Ospedale Evangelico Internazionale,
Corso Solferino 2,
16100,
Genoa.
