Keywords:
Musculoskeletal system, Neuroradiology peripheral nerve, MR, Imaging sequences, Other
Authors:
L. Pugh, T. Lloyd
DOI:
10.26044/ranzcr2022/R-0244
Methods and materials
Our imaging protocol is performed on a 3 Tesla platform with sequences consisting of 3D SPACE STIR images in a coronal plane orientated to the neurovascular bundle, sagittal Dixon T2 images and T1 weighted images with the imaged volume extending through the supraclavicular fossa to the humerus. Sequences are performed with the arm in both neutral position and in abduction with external rotation. Additionally, a sagittal T2 cervical spine is performed to assess cervical nerve roots.
We present five patients who were imaged with the arm in a neutral and abducted position with compression of the brachial plexus demonstrated within the costoclavicular space. No alternative explanation of compression identified other than this dynamic compression by normal structures. These patients were following in their surgery and post operative course.
A single previous paper by Demondion et al10 has analysed the normal costoclavicular distance in a group of asymptomatic volunteers. We derived a baseline distance using a cohort of the most recently imaged 50 patients between the ages of 18-50 (age range selected to match the patients within the case series) undergoing CT examination of the chest with the arms elevated. The minimum distance of the costoclavicular space was measured in the sagittal plane from the routine reformats.